Communication strategies in psychologically informed osteopathic practice: A case report

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Osteopathic Medicine Pub Date : 2023-03-01 DOI:10.1016/j.ijosm.2022.10.009
Hilary Abbey
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引用次数: 2

Abstract

Introduction

This paper presents qualitative data from communication between an osteopath and patient participating in a research study to develop a new psychologically informed pain management course.

Presentation

‘Adam’, aged 49, presented with persistent pain and multiple health problems including HIV and depression. His aim in joining the study was to find ways to stay independent.

Evaluation

Existing osteopathic evaluations of musculoskeletal dysfunction were supported by psychological assessments of health beliefs and coping strategies.

Intervention

Psychological and mindfulness exercises were integrated into six osteopathic treatment sessions to support symptom relief, patient learning and self-management.

Data analysis

Audio-recordings were analysed qualitatively using Linguistic Ethnography.

Outcomes

Communication moved from ‘mechanistic’ pain discourses about diagnosis and structural damage towards ‘facilitative’ narratives involving shared sense-making about broader embodied experiences. Physical outcomes were similar to previous osteopathic treatment but with longer lasting effects due to more effective self-management, decreased fear-avoidance and increased physical activity.

Conclusion

This patient reported that a psychologically informed pain management course had increased his body awareness and ability to live well despite pain. Individual case findings are not generalisable, but these data appear to support an ecological-enactive model of osteopathic practice and suggest promising directions for future research.

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心理知情整骨疗法实践中的沟通策略:一例报告
引言本文提供了整骨医生和参与研究的患者之间交流的定性数据,以开发一个新的心理知情疼痛管理课程。49岁的亚当患有持续的疼痛和多种健康问题,包括艾滋病毒和抑郁症。他参加这项研究的目的是想办法保持独立。评估对肌肉骨骼功能障碍的现有整骨评估得到了健康信念和应对策略的心理评估的支持。干预心理和正念练习被整合到六个整骨治疗疗程中,以支持症状缓解,患者学习和自我管理。数据分析使用语言民族志对录音进行了定性分析。结果交流从关于诊断和结构损伤的“机械式”疼痛话语转向了涉及对更广泛的具体体验的共同感知的“促进性”叙事。身体效果与之前的整骨治疗相似,但由于更有效的自我管理、减少恐惧和增加体力活动,效果更持久。结论该患者报告称,心理知情的疼痛管理课程提高了他的身体意识和尽管疼痛仍能良好生活的能力。个别病例的发现是不可概括的,但这些数据似乎支持整骨实践的生态行为模型,并为未来的研究提供了有希望的方向。
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来源期刊
CiteScore
2.20
自引率
36.80%
发文量
42
审稿时长
3 months
期刊介绍: The International Journal of Osteopathic Medicine is a peer-reviewed journal that provides for the publication of high quality research articles and review papers that are as broad as the many disciplines that influence and underpin the principles and practice of osteopathic medicine. Particular emphasis is given to basic science research, clinical epidemiology and health social science in relation to osteopathy and neuromusculoskeletal medicine. The Editorial Board encourages submission of articles based on both quantitative and qualitative research designs. The Editorial Board also aims to provide a forum for discourse and debate on any aspect of osteopathy and neuromusculoskeletal medicine with the aim of critically evaluating existing practices in regard to the diagnosis, treatment and management of patients with neuromusculoskeletal disorders and somatic dysfunction. All manuscripts submitted to the IJOM are subject to a blinded review process. The categories currently available for publication include reports of original research, review papers, commentaries and articles related to clinical practice, including case reports. Further details can be found in the IJOM Instructions for Authors. Manuscripts are accepted for publication with the understanding that no substantial part has been, or will be published elsewhere.
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