First Nations People Perspectives on Telehealth Physiotherapy: A Qualitative Study Focused on the Therapeutic Relationships

<bold>Introduction:</bold> Relationships are the core of Indigenous peoples' identity, and therapeutic relationships (TRs) are an integral part of the physical rehabilitation process, directly influencing health outcomes. However, participating in TRs can be difficult for First Nations People, particularly in the virtual landscape. Therefore, the purpose of this study is to explore First Nations People’s perspective on telehealth physiotherapy, with an emphasis on the virtual therapeutic relationship. <bold>Methods:</bold> A narrative qualitative study which utilised 1:1, semi-structured interviews were conducted with nineteen First Nations adults from remote and rural First Nation communities in British Columbia, Canada. Interviews were recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Three themes emerged from data analysis. <italic>Therapist’s attitude and rapport</italic> captured participants’ perceptions of what matters the most in how physiotherapists relate to First Nation People and carry out their work. <italic>Remote nature of virtual care</italic> encompassed the main challenges of virtual care visits, particularly how these were perceived to impact establishing and maintaining solid therapeutic relationships. <italic>Fostering culturally appropriate and safe telehealth physiotherapy</italic> focuses on what is needed to advance telehealth physiotherapy in a manner that respects and reflects First Nations cultures, equipping all involved parties to provide comprehensive and sensitive services. Conclusion: The pursuit of equitable healthcare for First Nations communities demands access and a thoughtful, culturally safe, trauma-informed, and holistic approach that addresses their needs.