Health-promoting physical activities for refugees from Syria – physiotherapists’ clinical reasoning

• Published in: Physiotherapy theory and practice Vol. 41; no. 3; pp. 602 - 616
• Main Authors: Lindahl, Marianne, Andersen, Signe, Rafn, Anne Vollen, Rafn, Jan, Præstegaard, Jeannette, Sønderskov, Anne Juul, Nielsen, Nina Odgaard
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 01.03.2025
• Subjects: Action research; Adult; Clinical assessment; Clinical decision making; Collaboration; Exercise; Female; Focus Groups; Health initiatives; Health promotion; Health Promotion - methods; Health status; Humans; Intervention; Male; Middle Aged; Musculoskeletal pain; Noncommunicable diseases; Physical therapists; Physical Therapists - psychology; Psychosocial factors; Refugees; Refugees - psychology; Sedentary; Self Efficacy; Social cognitive theory; Social environment; Syria - ethnology; Well being; Syria; group-based training; pain management; Social cognitive theory; salutogenic perspective; self-efficacy
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.1080/09593985.2024.2353244

Refugees from Syria face health challenges with psychosocial dimensions due to disrupted networks, uncertain life situations, and language barriers. Additionally, a sedentary lifestyle increases the risk of noncommunicable diseases, so health-promoting initiatives involving physical activities are essential. To explore physiotherapists' clinical reasoning and collaboration with refugee families in developing group-based health-promoting physical exercising to increase participants' wellbeing, sense of togetherness, and self-efficacy. The design was participating action research with 24 resettled refugees from Syria. Data consisted of field notes and three focus group interviews. Data gathering followed a phenomenological approach, and the four-step analysis was inspired by Giorgi. Based on clinical reasoning and collaboration with the participants and their wishes, the physiotherapists organized a physical exercise intervention integrating language learning. The physiotherapists based the intervention on social cognitive theory, focusing on the group's and the individual's capacity and working with the participants on exercise and organizational adaptations to the group and individual. The participants appreciated the joyful physical activities, body awareness, and a sense of togetherness. To accommodate that many suffered from musculoskeletal pain, the physiotherapists developed an intervention for therapeutic exercising that included individual assessment and pain management. The physiotherapists' clinical reasoning in working with refugees included the cultural, linguistic, and social context rooted in a salutogenic perspective. The participants' wellbeing and self-efficacy in adhering to exercise increased. They experienced pain relief and increased confidence in using the body.