Bridging troubled water -exploring improvement and patients' experiences using patient-reported outcome measures in physiotherapy: A mixed-method study (original) (raw)
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Patient Preference and Adherence, 2016
Background: Patient participation in goal setting is important to deliver client-centered care. In daily practice, however, patient involvement in goal setting is not optimal. Patient-specific instruments, such as the Patient Specific Complaints (PSC) instrument, can support the goalsetting process because patients can identify and rate their own problems. The aim of this study is to explore patients' experiences with the feasibility of the PSC, in the physiotherapy goal setting. Method: We performed a qualitative study. Data were collected by observations of physiotherapy sessions (n=23) and through interviews with patients (n=23) with chronic conditions in physiotherapy practices. Data were analyzed using directed content analysis. Results: The PSC was used at different moments and in different ways. Two feasibility themes were analyzed. First was the perceived ambiguity with the process of administration: patients perceived a broad range of experiences, such as emotional and supportive, as well as feeling a type of uncomfortableness. The second was the perceived usefulness: patients found the PSC useful for themselves-to increase awareness and motivation and to inform the physiotherapistas well as being useful for the physiotherapist-to determine appropriate treatment for their personal needs. Some patients did not perceive any usefulness and were not aware of any relation with their treatment. Patients with a more positive attitude toward questionnaires, patients with an active role, and health-literate patients appreciated the PSC and felt facilitated by it. Patients who lacked these attributes did not fully understand the PSC's process or purpose and let the physiotherapist take the lead. Conclusion: The PSC is a feasible tool to support patient participation in the physiotherapy goal setting. However, in the daily use of the PSC, patients are not always fully involved and informed. Patients reported varied experiences related to their personal attributes and modes of administration. This means that the PSC cannot be used in the same way in every patient. It is perfectly suited to use in a dialogue manner, which makes it very suitable to improve goal setting within client-centered care.
This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes. One session emerged as particularly stressful for both parties and is explored in detail in this article. In our analysis, we seek to be attentive to the experiences of physiotherapy displayed and to explore their meaning, significance and uniqueness from a phenomenological perspective. Our research reveals the complexity of integrating multiple theoretical perspectives of practice in clinical decisionmaking and suggests that a phenomenological perspective can provide insights into clinical encounters through its recognition of embodied knowledge. We argue that good physiotherapy practice demands tactfulness, sensitivity, and the desire to build a cooperative patient-therapist relationship. Informed by theoretical and practical knowledge from multiple disciplines, patient management can evolve and unfold beyond rehearsed routines and theoretical principles.
Archives of physiotherapy, 2018
The therapeutic relationship between patient and physiotherapist is a central component of patient-centred care and has been positively associated with better physiotherapy clinical outcomes. Despite its influence, we do not know what conditions enable a physiotherapist and patient to establish and maintain a therapeutic relationship. This knowledge has implications for how clinicians approach their interactions with patients and for the development of an assessment tool that accurately reflects the nature of the therapeutic relationship. Therefore, this study's aim was to identify and provide in-depth descriptions of the necessary conditions of engagement of the therapeutic relationship between physiotherapists and patients. Interpretive description was the qualitative methodological orientation used to identify and describe the conditions that reflect and are practically relevant to clinical practice. Eleven physiotherapists with a minimum 5 years of clinical experience and se...
Psychology for Physiotherapists
2009
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Journal of Manual & Manipulative Therapy, 2012
Objective: The Patient-Specific Functional Scale (PSFS) and the Numeric Pain Rating Scale (NPRS) are two measures which the Accident Compensation Corporation (ACC) of New Zealand have made compulsory for physiotherapists to record at a patients initial visit and discharge. Therefore, it is important to assess clinicians' compliance to this reporting requirement, and whether research results regarding effectiveness of these measures are transferable to the clinic. Method: A retrospective observational study that assessed compliance in recording these measures, and analyzed the changes in scores seen across 11 physiotherapy practices in New Zealand over a 12-month period.
PHYSIOTHERAPY AND CLINICAL APPROACHES – AN OVERVIEW
Physiotherapy (also Physical Therapy as referred to by the World Confederation of Physical Therapy) is a health care profession concerned with human function and movement and maximizing potential. It is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation. It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status. It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgment and informed interpretation is at its core.
Physiotherapy Research International, 1999
My research concern prevention and rehabilitation of musculoskeletal disorders from a biopsychosocial and human factors perspective with a focus on ergonomic, psychosocial and workorganizational interventions and occupational rehabilitation and method development in these areas. Within prevention my research deals with identifying the preventive effects of different healthy factors in an individuals work and/or life situation such as fall motivation, stress-preventive factors, physical activity, fall preventive factors, psychosocial, life-style and cultural factors and the importance of values and ethics. My research also deals with how rehabilitation can be of higher quality and more cost-effective as well as theoretical studies to develop the knowledge base in physiotherapy for example concerning movement quality, body awareness, psychosomatics.
Physiotherapy in the 21st century
The First Physical Therapy Summit on Global Health was convened at the 2007 World Confederation for Physical Therapy (WCPT) Congress to vision practice in the 21st century and, in turn, entry-level education and research, as informed by epidemiological indicators, and consistent with evidence-based noninvasive interventions, the hallmark of physical therapy. The Summit and its findings were informed by WHO data and validated through national databases of the countries of the five WCPT regions. The health priorities based on mortality were examined in relation to proportions of physical therapists practicing in the areas of regional priorities and of the curricula in entry-level programs. As a validation check and to contextualize the findings, input from members of the 800 Summit participants was integrated and international consultants refined the recommendations. Lifestyle-related conditions (ischemic heart disease, smoking-related conditions, hypertension, stroke, cancer, and diabetes) were leading causes of premature death across regions. Contemporary definitions of physical therapy support that the profession has a leading role in preventing, reversing, as well as managing lifestyle-related conditions. The proportions of practitioners practicing primarily in these priority areas and of the entry-level curricula based on these priorities were low. The proportions of practitioners in priority areas and entry-level curricula devoted to lifestylerelated conditions warrant being better aligned with the prevalence of these conditions across regions in the 21st century. A focus on clinical competencies associated with effective health education and health behavior change formulates the basis for The Second Physical Therapy Summit on Global Health. 532 Dean et al. Physiotherapy Theory and Practice 545 Physiotherapy Theory and Practice Physiother Theory Pract Downloaded from informahealthcare.com by University of Otago on 01/09/14 For personal use only.
Application of current research evidence to clinical physiotherapy practice
Journal of allied health, 2004
This paper reviews the nature of physiotherapy intervention studies published in core physiotherapy journals (Australian Journal of Physiotherapy, Physiotherapy Theory and Practice, Physical Therapy, Physiotherapy, and Physiotherapy Canada) between October 2001 and September 2002. The clinical applicability of their evidence was considered in light of the clinical relevance of diagnostic criteria used for subject recruitment, the nature of the interventions tested, and the outcome measures used to determine effectiveness of the intervention. Most studies investigated a "package of care" and used clinician-oriented measures of outcomes to determine the effectiveness of an intervention. This mirrors current clinical practice. However, few studies used tissue-based diagnostic criteria for subject recruitment, tested interventions within an episode-of-care model, or measured outcome from multiple stakeholders' perspectives. These findings highlight potential barriers for c...