How do physiotherapists solicit and explore patients’ concerns in back pain consultations : a conversation analytic approach

Cowell, Ian (Department of Surgery and Cancer, Imperial College London, London, United Kingdom) ; McGregor, Alison (Department of Surgery and Cancer, Imperial College London, London, United Kingdom) ; O’Sullivan, Peter (School of Physiotherapy and Exercise Science, Curtin University, Bentley Perth, WA, Australia ; Bodylogic Physiotherapy, Shenton Park, Perth, WA, Australia) ; O’Sullivan, Kieran (School of Allied Health, University of Limerick, Limerick, Ireland; Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar) ; Poyton, Ross (Department of Surgery and Cancer, Imperial College London, London, United Kingdom) ; Schoeb, Veronika (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Murtagh, Ged (Department of Surgery and Cancer, Imperial College London, London, United Kingdom)

Background: Guidelines advocate that non-specific chronic low back pain (NSCLBP) be considered within a multi-dimensional bio-psychosocial (BPS) framework. This BPS approach advocates incorporating the patient’s perspective as part of the treatment process. ‘Agenda setting’ has been introduced as the key to understanding patients’ concerns in medical encounters; however, this has received little attention in physiotherapy. This study explored how physiotherapists solicit and respond to the agenda of concerns that patients with NSCLBP bring to initial encounters. Method: The research setting was primary care. Twenty initial physiotherapy consultations were video-recorded, transcribed and analyzed using conversation analysis, a qualitative observational method. Both verbal and non-verbal features of the interaction were considered. Results: This data highlights a spectrum of communication styles ranging from more physiotherapist-focused, where the physiotherapists did not attend to patients’ concerns, to a more patient-focused style, which provided greater opportunities for patients to voice their concerns. On occasions, patients were willing to pursue their own agenda when their concern was initially overlooked. Conclusion: This study provides empirical evidence on communication patterns in physiotherapy practice. A more collaborative style of communication with a shared conversational agenda provided patients with the conversational space to describe their concerns more fully.


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Physiothérapie
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2021-06
Pagination:
18 p.
Published in:
Physiotherapy theory and practice
Numeration (vol. no.):
2021, vol. 37, no. 6, pp. 693-709
DOI:
ISSN:
0959-3985
Appears in Collection:

Note: The status of this file is: restricted


 Record created 2021-05-21, last modified 2021-05-25

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