Contextual factors influencing Canadian physiotherapists' clinical reasoning about older adult clients' finances and economics: A qualitative descriptive study.

Introduction: While physiotherapy can be beneficial for older adults, many experience financial barriers to accessing physiotherapy services. There is limited published evidence regarding how physiotherapists consider client finances in their work. Purpose: This study aimed to explore Canadian physi...

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Published in:Physiotherapy Theory & Practice Vol. 42; no. 4; pp. 554 - 567
Main Authors: Adedotun, Kafayat, Thille, Patricia, Conci, Sarah, Chesser, Stephanie, Engel, Lisa
Format: research tables/charts Journal Article
Published: Taylor & Francis Ltd Apr2026
Online Access:View this record in EBSCOhost
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      dt: Apr2026
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      pub: Taylor & Francis Ltd
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        10.1080/09593985.2025.2584355
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        atl: Contextual factors influencing Canadian physiotherapists' clinical reasoning about older adult clients' finances and economics: A qualitative descriptive study.
      aug:
        au:
          Adedotun, Kafayat
          Thille, Patricia
          Conci, Sarah
          Chesser, Stephanie
          Engel, Lisa
        affil: Department of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
      sug:
        subj:
          Physical Therapist Attitudes Canada
          Clinical Reasoning
          Health Services Accessibility In Old Age
          Physical Therapy Economics
          Human
          Male
          Female
          Aged
          Canada
          Qualitative Studies
          Economic Aspects of Illness
          Descriptive Research
          Reflexivity (Research)
          Purposive Sample
          Semi-Structured Interview
          Thematic Analysis
          Analytic Research
          Decision Making, Clinical
          Job Experience
          Funding Source
          Aged: 65+ years
          Male
          Female
      ab: Introduction: While physiotherapy can be beneficial for older adults, many experience financial barriers to accessing physiotherapy services. There is limited published evidence regarding how physiotherapists consider client finances in their work. Purpose: This study aimed to explore Canadian physiotherapists' current practice regarding the inclusion of clients' financial or economic context in clinical reasoning and to identify possible ways to improve physiotherapy services access. Methods: We interviewed nine physiotherapists practicing in Manitoba, Canada, using an in-depth semi-structured guide. We recorded and transcribed each interview and then analyzed transcripts thematically, building upon reflexive thematic analysis and framework approaches. Results: We generated three themes through our analysis: (1) considering older adults' finances in clinical reasoning depends on contextual factors internal and external to the physiotherapists, (2) learning about clients' finances influenced physiotherapists' clinical reasoning, and (3) physiotherapists used varied approaches to address the needs of clients with limited finance. Internal factors included physiotherapists not knowing how to discuss finances with clients and physiotherapists' need to make a liveable wage. External factors included limited resources available to address the needs of clients with limited finances and physiotherapists' caseloads. Conclusions: Including older adults' finances in clinical reasoning is a complex process. There may be a need for systemic changes, such as provision of workplace processes and resources, to encourage physiotherapists to include clients' finances in clinical reasoning. The findings point to the need for educational programs for physiotherapists to ensure comfort and confidence with including finances as part of their standard practice.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Unknown
    language: English
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