Physiotherapists' Approaches to Patients' Concerns in Back Pain Consultations Following a Psychologically Informed Training Program

Qual Health Res. 2021 Nov;31(13):2486-2501. doi: 10.1177/10497323211037651. Epub 2021 Oct 7.

Abstract

Guidelines advocate a combined physical and psychological approach to managing non-specific chronic low back pain (NSCLBP), referred to as psychologically informed practice (PIP). PIP is underpinned by patient-centered principles and skilled communication. Evidence suggests that a physiotherapist-focused style of communication prevails in physiotherapy. There is a recognized need for observational research to identify specific communication practices in physiotherapy interactions. This observational study explored the interactional negotiation of agenda setting following a PIP training intervention, by identifying and describing how physiotherapists solicit and respond to the agenda of concerns that patients with NSCLBP bring to primary care initial encounters. The research setting was primary care. Nineteen initial physiotherapy consultations were video-recorded, transcribed, and analyzed using conversation analysis, a qualitative observational method. These data revealed a patient-focused style of communication where trained physiotherapists demonstrated a collaborative and responsive style of verbal and nonverbal communication to solicit, explore, and validate patients' concerns.

Keywords: United Kingdom; communication; conversation analysis; physiotherapy; psychologically informed practice; qualitative; training.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Humans
  • Low Back Pain* / therapy
  • Physical Therapists*
  • Physical Therapy Modalities
  • Professional-Patient Relations
  • Referral and Consultation
  • Research Design