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

Physiotherapy Theory and Practice
Ian CowellGed Murtagh

Abstract

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...Continue Reading

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Citations

Jul 4, 2020·Brazilian Journal of Physical Therapy·J P CaneiroPeter O'Sullivan
Aug 3, 2020·Brazilian Journal of Physical Therapy·Roberto Costa KrugJefferson Fagundes Loss
Aug 12, 2021·Musculoskeletal Science & Practice·Nathan HuttingLisa Roberts

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