Pub Date : 2022-05-27DOI: 10.1080/21679169.2022.2080252
Niko Brenner, M. Ross, Eugénie McLachlan, R. McKinnon, Lorna Moulton, J. Hammond
Abstract Background Individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual or related identities (LGBTQIA+) experience barriers when accessing healthcare, including physiotherapy. Little is known about physiotherapy students’ attitudes and beliefs about caring for LGBTQIA+ individuals and what education is provided. Purpose This study aims to identify the attitudes, knowledge and practice of physiotherapy students when caring for LGBTQIA+ patients in the UK. Methods A cross-sectional online survey of physiotherapy students. Independent sample t-tests and an analysis of variance were carried out to analyse between-group differences in heteronormativity scores (modified Heteronormative Attitudes and Beliefs Scale (HABS)) and respondents’ attitudes and beliefs about caring for LGBTQIA+ individuals. Results 107 eligible participants completed the questionnaire with 23% identifying as LGBTQIA + and 41% indicating close personal exposure to LGBTQIA+ people. Clinical placement experience and experience working with LGBTQIA+ people in other professional roles was reported by 16%, 27% respectively. Educational exposure (with a mean (standard deviation (SD)) of 2.7 (2.9) h) to the LGBTQIA + community was reported by 17% of participants. The overall mean (SD) modified-HABS score was 2.65 (1.20). Participants with greater personal and informal educational exposure to LGBTQIA+ topics demonstrated less heteronormative attitudes and beliefs, greater awareness and more inclusive attitudes towards caring for LGBTQIA+ individuals compared to those without. Conclusion Physiotherapy students have generally positive attitudes towards providing care for LGBTQIA+ individuals. Education is inconsistent and physiotherapy students lack awareness of LGBTQIA+ specific healthcare needs. These findings suggest that more focus is needed on LGBTQIA+ healthcare within physiotherapy education.
{"title":"Physiotherapy students’ education on, exposure to, and attitudes and beliefs about providing care for LGBTQIA+ patients: a cross-sectional study in the UK","authors":"Niko Brenner, M. Ross, Eugénie McLachlan, R. McKinnon, Lorna Moulton, J. Hammond","doi":"10.1080/21679169.2022.2080252","DOIUrl":"https://doi.org/10.1080/21679169.2022.2080252","url":null,"abstract":"Abstract Background Individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual or related identities (LGBTQIA+) experience barriers when accessing healthcare, including physiotherapy. Little is known about physiotherapy students’ attitudes and beliefs about caring for LGBTQIA+ individuals and what education is provided. Purpose This study aims to identify the attitudes, knowledge and practice of physiotherapy students when caring for LGBTQIA+ patients in the UK. Methods A cross-sectional online survey of physiotherapy students. Independent sample t-tests and an analysis of variance were carried out to analyse between-group differences in heteronormativity scores (modified Heteronormative Attitudes and Beliefs Scale (HABS)) and respondents’ attitudes and beliefs about caring for LGBTQIA+ individuals. Results 107 eligible participants completed the questionnaire with 23% identifying as LGBTQIA + and 41% indicating close personal exposure to LGBTQIA+ people. Clinical placement experience and experience working with LGBTQIA+ people in other professional roles was reported by 16%, 27% respectively. Educational exposure (with a mean (standard deviation (SD)) of 2.7 (2.9) h) to the LGBTQIA + community was reported by 17% of participants. The overall mean (SD) modified-HABS score was 2.65 (1.20). Participants with greater personal and informal educational exposure to LGBTQIA+ topics demonstrated less heteronormative attitudes and beliefs, greater awareness and more inclusive attitudes towards caring for LGBTQIA+ individuals compared to those without. Conclusion Physiotherapy students have generally positive attitudes towards providing care for LGBTQIA+ individuals. Education is inconsistent and physiotherapy students lack awareness of LGBTQIA+ specific healthcare needs. These findings suggest that more focus is needed on LGBTQIA+ healthcare within physiotherapy education.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44881568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1080/21679169.2022.2072523
J. Femiak, Marcin Czechowski
Abstract Purpose In the context of the COVID-19 pandemic, the need arose for replacing conventional forms of education with remote classes. Therefore, it was decided to test the effectiveness of a social skills workshop conducted using active online methods for second-year physiotherapy students. Methods The experimental factor was the contents of workshop classes taught online. The platforms Teams, Zoom and the Messenger were used to carry out the experiment. The workshops used active learning methods: simulation of work situation, drama, peer feedback and interaction-based communication. Results The results obtained from 78 participants (pre-test and post-test, including 45 women) were analysed. The age of the participants ranged from 20 to 22 years, with a mean of 20.7 years. A self-reported social skills questionnaire consisting of 30 statements was used. Participation in the course resulted in a significant increase in the index of general social competences of the students (F1.76=38.66; p < .0001; η2=.337; observed power (for α = .05) 1 − β > 0.99. There was no interaction between course participation and the gender of the participants (p = .0849). Conclusions Online workshops using active teaching methods, which are an essential element of future physiotherapists’ preparation for clinical work, can stimulate the development of their social skills.
{"title":"Do online workshops using active teaching methods improve self-rated social skills of future physiotherapists?","authors":"J. Femiak, Marcin Czechowski","doi":"10.1080/21679169.2022.2072523","DOIUrl":"https://doi.org/10.1080/21679169.2022.2072523","url":null,"abstract":"Abstract Purpose In the context of the COVID-19 pandemic, the need arose for replacing conventional forms of education with remote classes. Therefore, it was decided to test the effectiveness of a social skills workshop conducted using active online methods for second-year physiotherapy students. Methods The experimental factor was the contents of workshop classes taught online. The platforms Teams, Zoom and the Messenger were used to carry out the experiment. The workshops used active learning methods: simulation of work situation, drama, peer feedback and interaction-based communication. Results The results obtained from 78 participants (pre-test and post-test, including 45 women) were analysed. The age of the participants ranged from 20 to 22 years, with a mean of 20.7 years. A self-reported social skills questionnaire consisting of 30 statements was used. Participation in the course resulted in a significant increase in the index of general social competences of the students (F1.76=38.66; p < .0001; η2=.337; observed power (for α = .05) 1 − β > 0.99. There was no interaction between course participation and the gender of the participants (p = .0849). Conclusions Online workshops using active teaching methods, which are an essential element of future physiotherapists’ preparation for clinical work, can stimulate the development of their social skills.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42701732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1080/21679169.2022.2073991
M. Elkins, R. Pinto, A. Verhagen, M. Grygorowicz, A. Söderlund, Matthieu Guémann, A. Gómez-Conesa, Sarah Blanton, J. Brismée, S. Agarwal, Alan Jette, S. Karstens, M. Harms, G. Verheyden, Umer Sheikh
Null hypothesis statistical tests are often conducted in healthcare research [1], including in the physiotherapy field [2]. Despite their widespread use, null hypothesis statistical tests have important limitations. This co-published editorial explains statistical inference using null hypothesis statistical tests and the problems inherent to this approach; examines an alternative approach for statistical inference (known as estimation); and encourages readers of physiotherapy research to become familiar with estimation methods and how the results are interpreted. It also advises researchers that some physiotherapy journals that are members of the International Society of Physiotherapy Journal Editors (ISPJE) will be expecting manuscripts to use estimation methods instead of null hypothesis statistical tests.
{"title":"Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors","authors":"M. Elkins, R. Pinto, A. Verhagen, M. Grygorowicz, A. Söderlund, Matthieu Guémann, A. Gómez-Conesa, Sarah Blanton, J. Brismée, S. Agarwal, Alan Jette, S. Karstens, M. Harms, G. Verheyden, Umer Sheikh","doi":"10.1080/21679169.2022.2073991","DOIUrl":"https://doi.org/10.1080/21679169.2022.2073991","url":null,"abstract":"Null hypothesis statistical tests are often conducted in healthcare research [1], including in the physiotherapy field [2]. Despite their widespread use, null hypothesis statistical tests have important limitations. This co-published editorial explains statistical inference using null hypothesis statistical tests and the problems inherent to this approach; examines an alternative approach for statistical inference (known as estimation); and encourages readers of physiotherapy research to become familiar with estimation methods and how the results are interpreted. It also advises researchers that some physiotherapy journals that are members of the International Society of Physiotherapy Journal Editors (ISPJE) will be expecting manuscripts to use estimation methods instead of null hypothesis statistical tests.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43100706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose To establish an inventory of the Evidence-Based Practice (EBP) among physiotherapists (PT) in France assessing EBP knowledge, perception, and utilisation in practice. Method A cross-sectional survey was performed using a French translation of the EBP2 questionnaire including the 5 EBP domains (Relevance, Terminology, Confidence, Practice and Sympathy). Participants completed the online survey from February 26th to August 31st, 2021. Scores were summarised by EBP domain for each participant. Pairwise Pearson’s correlations between domains scores and a hierarchical clustering on principal component analysis were conducted. Results In total, 542 participants were included in the analysis. Majority of participants were male with median age of 30 years (IQR: 26–36 years). Regarding EBP domain scores, PT perceived relevance of EBP but had difficulty to apply it in practice. Furthermore, positive correlations exist between the 5 domains. Participants were divided into three clusters. Those reporting poor scientific analysis skills and high barriers were older, less graduated, less trained in EBP and graduated earlier. Conclusion French PT perceived research to be important in their current practice and had a favourable opinion of EBP. However, they reported a lack of confidence, difficulty to understand terminology and to use it in practice. These findings and their profiles may help to improve PT’s EBP education in France.
{"title":"Evidence-based-practice profile among physiotherapists: a cross-sectional survey in France","authors":"Arnaud Bruchard, Xavier Laurent, Pauline Raul, Germain Saniel, Grégory Visery, Vincent Fontanier, Nadège Lemeunier","doi":"10.1080/21679169.2022.2057587","DOIUrl":"https://doi.org/10.1080/21679169.2022.2057587","url":null,"abstract":"Abstract Purpose To establish an inventory of the Evidence-Based Practice (EBP) among physiotherapists (PT) in France assessing EBP knowledge, perception, and utilisation in practice. Method A cross-sectional survey was performed using a French translation of the EBP2 questionnaire including the 5 EBP domains (Relevance, Terminology, Confidence, Practice and Sympathy). Participants completed the online survey from February 26th to August 31st, 2021. Scores were summarised by EBP domain for each participant. Pairwise Pearson’s correlations between domains scores and a hierarchical clustering on principal component analysis were conducted. Results In total, 542 participants were included in the analysis. Majority of participants were male with median age of 30 years (IQR: 26–36 years). Regarding EBP domain scores, PT perceived relevance of EBP but had difficulty to apply it in practice. Furthermore, positive correlations exist between the 5 domains. Participants were divided into three clusters. Those reporting poor scientific analysis skills and high barriers were older, less graduated, less trained in EBP and graduated earlier. Conclusion French PT perceived research to be important in their current practice and had a favourable opinion of EBP. However, they reported a lack of confidence, difficulty to understand terminology and to use it in practice. These findings and their profiles may help to improve PT’s EBP education in France.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48100897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1080/21679169.2022.2059104
Liselotte Jensen, Tine Eva Rasmussen, Marianne Lindahl
Abstract Purpose The aim of this classic grounded theory study was to develop a substantive theory explaining variations in patients’ expectations of physiotherapists when contacting a clinic. Materials and methods The study was nested in a survey cohort study, and data constituted a single open-ended question: State what you expect the physiotherapist to help you with. Responses were obtained from patients before attending the clinic. Statements were analysed using classic grounded theory with open, selective, and theoretical coding. The authors concurrently used memos and constant comparison until theoretical saturation was achieved, categories were identified, and a theoretical model was developed. Results Based on 292 statements from patients primarily suffering from musculoskeletal problems, the theory grounded in data Expectations as a continuum was developed. Four typologies created the theory: (1) Doing something, so it is again possible to…, (2) Finding out what is wrong with me, (3) Relieving/getting rid of symptoms, and (4) Help to self-help. Conclusions The theory Expectations as a continuum illuminates that patients’ expectations range from helplessness to being competent to act and reflect the social cognitive theories health locus of control and self-efficacy. Patients’ abilities for self-management are different, and physiotherapists should carefully adjust the requirements for self-management.
{"title":"What do patients expect from physiotherapists in private clinics? A classical grounded theory study","authors":"Liselotte Jensen, Tine Eva Rasmussen, Marianne Lindahl","doi":"10.1080/21679169.2022.2059104","DOIUrl":"https://doi.org/10.1080/21679169.2022.2059104","url":null,"abstract":"Abstract Purpose The aim of this classic grounded theory study was to develop a substantive theory explaining variations in patients’ expectations of physiotherapists when contacting a clinic. Materials and methods The study was nested in a survey cohort study, and data constituted a single open-ended question: State what you expect the physiotherapist to help you with. Responses were obtained from patients before attending the clinic. Statements were analysed using classic grounded theory with open, selective, and theoretical coding. The authors concurrently used memos and constant comparison until theoretical saturation was achieved, categories were identified, and a theoretical model was developed. Results Based on 292 statements from patients primarily suffering from musculoskeletal problems, the theory grounded in data Expectations as a continuum was developed. Four typologies created the theory: (1) Doing something, so it is again possible to…, (2) Finding out what is wrong with me, (3) Relieving/getting rid of symptoms, and (4) Help to self-help. Conclusions The theory Expectations as a continuum illuminates that patients’ expectations range from helplessness to being competent to act and reflect the social cognitive theories health locus of control and self-efficacy. Patients’ abilities for self-management are different, and physiotherapists should carefully adjust the requirements for self-management.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-08DOI: 10.1080/21679169.2022.2052178
Sajiri Joshi, Sona Kolke
Abstract Background Sensorimotor dysfunction is one of the factors leading to advancement of knee osteoarthritis (OA). Limited evidence supports the use of neuromuscular training (NMT) incorporating all the elements of sensorimotor function viz. strength, balance, coordination, and proprioception, hence the current study aimed to evaluate the efficacy of NMT integrating all aspects of sensorimotor function on pain, function, and balance in patients with knee OA. Material and methods This single-blinded RCT recruited 62 subjects (40–65 years) with KL grade II-III of knee OA, who were randomly allocated into two groups namely NMT or strengthening group (twice a week for 6 weeks). Outcomes were assessed for pain (NPRS), function (CRD version of WOMAC, PSFS, chair stand test, stair climb test, timed up and go test), and balance (Y-balance) at baseline and at the completion of the intervention. Results 54 subjects completed the trial. Although both groups had significant improvement NMT was more effective (p value < 0.05) for most clinical outcomes of NPRS, Y-balance, and WOMAC with low-moderate effect size and objective functional tests – chair stand test and timed up and go test. Conclusion NMT was more effective in improving the clinical outcomes of pain, function (except PSFS), and balance in subjects with KL grade II-III knee OA. Knee OA patients may benefit with addition of NMT to their intervention. However, due to limitations of low effect size, the results should be considered with caution.
{"title":"Effects of progressive neuromuscular training on pain, function, and balance in patients with knee osteoarthritis: a randomised controlled trial","authors":"Sajiri Joshi, Sona Kolke","doi":"10.1080/21679169.2022.2052178","DOIUrl":"https://doi.org/10.1080/21679169.2022.2052178","url":null,"abstract":"Abstract Background Sensorimotor dysfunction is one of the factors leading to advancement of knee osteoarthritis (OA). Limited evidence supports the use of neuromuscular training (NMT) incorporating all the elements of sensorimotor function viz. strength, balance, coordination, and proprioception, hence the current study aimed to evaluate the efficacy of NMT integrating all aspects of sensorimotor function on pain, function, and balance in patients with knee OA. Material and methods This single-blinded RCT recruited 62 subjects (40–65 years) with KL grade II-III of knee OA, who were randomly allocated into two groups namely NMT or strengthening group (twice a week for 6 weeks). Outcomes were assessed for pain (NPRS), function (CRD version of WOMAC, PSFS, chair stand test, stair climb test, timed up and go test), and balance (Y-balance) at baseline and at the completion of the intervention. Results 54 subjects completed the trial. Although both groups had significant improvement NMT was more effective (p value < 0.05) for most clinical outcomes of NPRS, Y-balance, and WOMAC with low-moderate effect size and objective functional tests – chair stand test and timed up and go test. Conclusion NMT was more effective in improving the clinical outcomes of pain, function (except PSFS), and balance in subjects with KL grade II-III knee OA. Knee OA patients may benefit with addition of NMT to their intervention. However, due to limitations of low effect size, the results should be considered with caution.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44423981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-10DOI: 10.1080/21679169.2022.2047781
Jack Davis, C. Newton, Gurpreet Singh, David Nolan, K. O’Sullivan
Abstract Background Back pain (BP) is a major cause of absenteeism in National Health Service (NHS) staff in the UK. However, the back beliefs of NHS staff with BP are unknown. Objectives To explore the BP beliefs of UK NHS staff presenting with BP, and how these beliefs are constructed. Method Purposive sampling of NHS staff with BP who had self-referred to University Hospitals of Leicester NHS Trusts occupational health physiotherapy service. 30 participants completed the Back-Pain Attitudes Questionnaire. Ten participants with a range of BP beliefs also completed semi-structured interviews. Mean responses, and frequency of different responses were reported, for the questionnaire data. Interviews were analysed using thematic analysis. Results Total Back-PAQ scores (mean −9.6, SD 9.16) indicated unhelpful BP beliefs overall, though some BP beliefs such as the potential benefit of exercise were more positive. Key themes identified from the interviews were; (i) the uniquely vulnerable nature of BP, (ii) the need to protect the back through avoidance behaviours, and (iii) the importance of being active for BP. Conclusion NHS staff presenting with BP generally held negative BP beliefs, based on both questionnaire responses and the qualitative interviews. Awareness of the potential benefits of activity contrasted with the notion that ongoing protection of the back was required, and was evident in questionnaire data and interviews. Back pain beliefs were influenced by health care professional advice (both formal and informal settings), moving and handling training, family opinion and childhood experiences, offering insights into the settings where BP beliefs could be targeted.
{"title":"‘Keep moving, but carefully’: back pain beliefs among NHS staff","authors":"Jack Davis, C. Newton, Gurpreet Singh, David Nolan, K. O’Sullivan","doi":"10.1080/21679169.2022.2047781","DOIUrl":"https://doi.org/10.1080/21679169.2022.2047781","url":null,"abstract":"Abstract Background Back pain (BP) is a major cause of absenteeism in National Health Service (NHS) staff in the UK. However, the back beliefs of NHS staff with BP are unknown. Objectives To explore the BP beliefs of UK NHS staff presenting with BP, and how these beliefs are constructed. Method Purposive sampling of NHS staff with BP who had self-referred to University Hospitals of Leicester NHS Trusts occupational health physiotherapy service. 30 participants completed the Back-Pain Attitudes Questionnaire. Ten participants with a range of BP beliefs also completed semi-structured interviews. Mean responses, and frequency of different responses were reported, for the questionnaire data. Interviews were analysed using thematic analysis. Results Total Back-PAQ scores (mean −9.6, SD 9.16) indicated unhelpful BP beliefs overall, though some BP beliefs such as the potential benefit of exercise were more positive. Key themes identified from the interviews were; (i) the uniquely vulnerable nature of BP, (ii) the need to protect the back through avoidance behaviours, and (iii) the importance of being active for BP. Conclusion NHS staff presenting with BP generally held negative BP beliefs, based on both questionnaire responses and the qualitative interviews. Awareness of the potential benefits of activity contrasted with the notion that ongoing protection of the back was required, and was evident in questionnaire data and interviews. Back pain beliefs were influenced by health care professional advice (both formal and informal settings), moving and handling training, family opinion and childhood experiences, offering insights into the settings where BP beliefs could be targeted.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44272773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1080/21679169.2022.2044140
A. Söderlund
Adherence in pain treatment in clinical practice and research is critical. Further, an important component in managing chronic pain, but also in other chronic conditions, is supporting patients to develop and engage in new behaviours, e.g. using self-management strategies that need to be sustained over time. However, how to effectively support and increase adherence to treatment representing a new behaviour is not clear. The adherence concept is considered as a development of the compliance concept. Compliance from a patient’s point of view is not an autonomous decision-making process. It is more of following orders from physiotherapist or other health care staff. Adherence however is a patient-centered communication of recommendation where the patient independently decides against or for a mutual agreement and advice. For the past few decades there has been little attention on strategies to increase adherence to achieve sustained behavioural change. The past research has focussed on the problems of non-adherence rather than studying solutions of supporting adherence. There is a great need of advancing in our understanding of how to handle the key barriers to adherence and how to coach changes in patient’s or client’s adherence behaviour in pain self-management. Also, the App and Web-based strategies to promote adherence in treatments for chronic pain and other chronic conditions do need to be studied. Significant levels of adherence to physical activity and exercise programs have shown high correlations with positive outcomes in pain management. However, research on effective strategies for supporting adherence is lacking. Very likely, patients’ and clients’ beliefs, cognitions, and emotions play an important role in finding successful and supportive behaviour change strategies for adherence. In a scoping review, it was shown that for supporting adherence, capability-related strategies such as education of the patient, supervision, mastery of and grading of activities and exercise aiming to increase self-efficacy were important. Further, motivation increasing strategies such as identifying readiness for change, self-monitoring of behaviour and goal setting seem to have positive impact on adherence. Additionally, strategies that could be related to opportunity for change were having booster sessions, getting feedback from therapist or significant others as well as social support facilitated adherence to activities and exercise [1]. Understanding and applying strategies for increasing adherence to the pain self-management regimes in research and clinical work is essential to improve long-term pain outcomes. It is time to address these interventional behaviour change-related challenges in pain self-management within clinical practice and research.
{"title":"Supporting patients’ adherence in pain self-management: how to proceed? – Editorial","authors":"A. Söderlund","doi":"10.1080/21679169.2022.2044140","DOIUrl":"https://doi.org/10.1080/21679169.2022.2044140","url":null,"abstract":"Adherence in pain treatment in clinical practice and research is critical. Further, an important component in managing chronic pain, but also in other chronic conditions, is supporting patients to develop and engage in new behaviours, e.g. using self-management strategies that need to be sustained over time. However, how to effectively support and increase adherence to treatment representing a new behaviour is not clear. The adherence concept is considered as a development of the compliance concept. Compliance from a patient’s point of view is not an autonomous decision-making process. It is more of following orders from physiotherapist or other health care staff. Adherence however is a patient-centered communication of recommendation where the patient independently decides against or for a mutual agreement and advice. For the past few decades there has been little attention on strategies to increase adherence to achieve sustained behavioural change. The past research has focussed on the problems of non-adherence rather than studying solutions of supporting adherence. There is a great need of advancing in our understanding of how to handle the key barriers to adherence and how to coach changes in patient’s or client’s adherence behaviour in pain self-management. Also, the App and Web-based strategies to promote adherence in treatments for chronic pain and other chronic conditions do need to be studied. Significant levels of adherence to physical activity and exercise programs have shown high correlations with positive outcomes in pain management. However, research on effective strategies for supporting adherence is lacking. Very likely, patients’ and clients’ beliefs, cognitions, and emotions play an important role in finding successful and supportive behaviour change strategies for adherence. In a scoping review, it was shown that for supporting adherence, capability-related strategies such as education of the patient, supervision, mastery of and grading of activities and exercise aiming to increase self-efficacy were important. Further, motivation increasing strategies such as identifying readiness for change, self-monitoring of behaviour and goal setting seem to have positive impact on adherence. Additionally, strategies that could be related to opportunity for change were having booster sessions, getting feedback from therapist or significant others as well as social support facilitated adherence to activities and exercise [1]. Understanding and applying strategies for increasing adherence to the pain self-management regimes in research and clinical work is essential to improve long-term pain outcomes. It is time to address these interventional behaviour change-related challenges in pain self-management within clinical practice and research.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41623767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-23DOI: 10.1080/21679169.2022.2032825
Liss Marita Solbakken, M. Nordhaug, K. Halvorsen
Abstract Purpose Physiotherapy is an important, integral part of rehabilitation after stroke. The study aim was to explore and describe patients’ experiences of involvement, motivation, and coping in interaction with physiotherapists during subacute stroke rehabilitation. Methods The data derive from qualitative semi-structured interviews of six patients following subacute stroke rehabilitation. The interviews were analysed using systematic text condensation. Results Two categories were identified: (1) ‘The physiotherapist’s contribution’, including the themes of motivation through goal attainment, transferring knowledge, and building self-efficacy through a good relationship; (2) ‘The patient’s internal process’, including the themes of attitude and determination, comparison, the importance of feeling well and fending off passivity. Conclusion This study shows that increased knowledge and a good relationship with the physiotherapist were important for the participants’ involvement, motivation, and coping. Experiencing ownership of the rehabilitation process made the patients accountable, affected their activity level positively, and helped them cope with their challenges.
{"title":"Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study","authors":"Liss Marita Solbakken, M. Nordhaug, K. Halvorsen","doi":"10.1080/21679169.2022.2032825","DOIUrl":"https://doi.org/10.1080/21679169.2022.2032825","url":null,"abstract":"Abstract Purpose Physiotherapy is an important, integral part of rehabilitation after stroke. The study aim was to explore and describe patients’ experiences of involvement, motivation, and coping in interaction with physiotherapists during subacute stroke rehabilitation. Methods The data derive from qualitative semi-structured interviews of six patients following subacute stroke rehabilitation. The interviews were analysed using systematic text condensation. Results Two categories were identified: (1) ‘The physiotherapist’s contribution’, including the themes of motivation through goal attainment, transferring knowledge, and building self-efficacy through a good relationship; (2) ‘The patient’s internal process’, including the themes of attitude and determination, comparison, the importance of feeling well and fending off passivity. Conclusion This study shows that increased knowledge and a good relationship with the physiotherapist were important for the participants’ involvement, motivation, and coping. Experiencing ownership of the rehabilitation process made the patients accountable, affected their activity level positively, and helped them cope with their challenges.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48259530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-11DOI: 10.1080/21679169.2022.2038264
S. Vooturi, A. Lakshmi, S. Jayalakshmi
Abstract Objective We evaluate adherence to tailor made, short-term home exercise programme in adult people with epilepsy (PWE), with seizures controlled on anti-seizure medications (ASM). Methods Demographic, clinical, quality of life (QoL) and physical fitness data of 116 PWE. Participants were prescribed tailor-made home-based exercises for 3 months. At follow-up, adherence to exercise was evaluated using self-reported Exercise Adherence Rating Scale (EARS). Results Average age of the study population was 29.93 ± 10.20(18–52) years; with 46 (39.6%) women. At enrolment, none of the participants reported to be physically active and the average body mass index (BMI) was 28.40 ± 5.79(18.2–41.4). The average distance walked in a six-minute walk test was 385.95 ± 63.48(240–510) metres. On QoL analysis, the mean Physical component score was 45.57 ± 8.72(25.7–62.6) and Mental component core was 45.41 ± 10.37(20.9–64.9). On EARS, 31(26.7%) participants reported doing exercises as recommended. Among PWE who were non-adherent to exercise, 68(58.6%) reported fear of possible seizure as a barrier for exercise, 63(54.3%) reported lack of support from family and friends. Having no fear about exercise (r = 0.640; p < 0.001) and encouragement of family were associated with adherence to exercise (r = 0.463; p < 0.001). Conclusion Adherence to home-based physical exercise is reported in one-fourth of PWE. Non-compliance to exercise in PWE is multi-factorial, support from family and friends and counselling may be helpful. Trial Registration CTRI/2014/10/005125
{"title":"Adherence to exercise in people with epilepsy","authors":"S. Vooturi, A. Lakshmi, S. Jayalakshmi","doi":"10.1080/21679169.2022.2038264","DOIUrl":"https://doi.org/10.1080/21679169.2022.2038264","url":null,"abstract":"Abstract Objective We evaluate adherence to tailor made, short-term home exercise programme in adult people with epilepsy (PWE), with seizures controlled on anti-seizure medications (ASM). Methods Demographic, clinical, quality of life (QoL) and physical fitness data of 116 PWE. Participants were prescribed tailor-made home-based exercises for 3 months. At follow-up, adherence to exercise was evaluated using self-reported Exercise Adherence Rating Scale (EARS). Results Average age of the study population was 29.93 ± 10.20(18–52) years; with 46 (39.6%) women. At enrolment, none of the participants reported to be physically active and the average body mass index (BMI) was 28.40 ± 5.79(18.2–41.4). The average distance walked in a six-minute walk test was 385.95 ± 63.48(240–510) metres. On QoL analysis, the mean Physical component score was 45.57 ± 8.72(25.7–62.6) and Mental component core was 45.41 ± 10.37(20.9–64.9). On EARS, 31(26.7%) participants reported doing exercises as recommended. Among PWE who were non-adherent to exercise, 68(58.6%) reported fear of possible seizure as a barrier for exercise, 63(54.3%) reported lack of support from family and friends. Having no fear about exercise (r = 0.640; p < 0.001) and encouragement of family were associated with adherence to exercise (r = 0.463; p < 0.001). Conclusion Adherence to home-based physical exercise is reported in one-fourth of PWE. Non-compliance to exercise in PWE is multi-factorial, support from family and friends and counselling may be helpful. Trial Registration CTRI/2014/10/005125","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47636217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}