Testa M1, Geri T1, Palese A2, Maselli F1, Viceconti A1, Camerone E1,3, Rossettini G1
1University of Genoa, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Savona, Italy, 2University of Udine, Department of Medical and Biological Sciences, Udine, Italy, 3University of AalborgTurin, Department of Neuroscience, Turino, Italy
Background: Contextual factors (CFs) seem to influence the physiotherapy outcome by facilitating placebo and nocebo effects. Recently, was proposed a model for clinical implementation of CFs organised in five categories (Testa &Rossettini 2016) respectively related to: physiotherapist (e.g. uniform, reputation), patient (e.g. expectations, previous experience), patient-physiotherapist relationship (e.g. verbal and non-verbal communication), treatment (e.g. therapeutic touch, overt therapy) and healthcare setting (e.g. design, architecture). While a sufficient knowledge of potentialities of CFs is present among physiotherapists, to date the degree of patients' knowledge about CFs in physiotherapy is unknown.
Purpose: The aim of this study was to investigate beliefs and attitudes of Italian patients affected by musculoskeletal pain regarding CFs.
Methods: A national sample of Italian patients with musculoskeletal pain was recruited from 12 outpatients private physiotherapy clinics situated in different regions of Italy. An invitation to participate in an online survey was sent to patient presenting:
1) musculoskeletal pain;
2) 18-75 years;
3) valid e-mail account;
4) understanding of Italian language.
Survey Monkey software was used to deliver the survey. The questionnaire was a self-report of the behavior, beliefs and attitudes of patients towards the adoption of CFs in physical therapy practice. Data were analysed by descriptive statistics and frequencies to describe the actual number of respondents to each question.
Results: 1112 patients were invited and all participated in the survey (100 %). 575 participants were female (52%), 538 (48%) were male. The mean age was 41.67 ± 15.3 years (range 18-74 years). They believed that:
- specific CFs such as therapeutic alliance (49%) and information provided by physiotherapists (52%) could influence therapeutic outcomes;
- a real effect of CFs can occur in acute pain (57%), chronic pain (56%) and rheumatologic disorders (40%);
- the use of CF when it exerts beneficial psychological effects (77%) is considerable ethically acceptable;
- the use of CFs should be banned when it is based on deception (66%);
- therapeutic power of CF is explained through body-mind connections (59%).
Moreover they expressed the desire to be informed about the adoption of CFs during the clinical encounter (62%) and positively accept the adoption of CFs as addition to other physical therapy interventions to optimize clinical responses (62%).
Conclusion(s): Italian patients, affected by musculoskeletal disorders, mostly had positive attitudes towards the implementation of CFs associated with physiotherapy and considered their adoption ethically correct.
Implications: The positive patients' view towards the therapeutic use of CFs offers to the physiotherapy community of practice the opportunity to systematically enhance their adoption in clinical setting and stimulates to study their specific effects by randomized controlled trial.
Keywords: placebo effects, contextual factors, musculoskeletal pain
Funding acknowledgements: This work was unfunded
Purpose: The aim of this study was to investigate beliefs and attitudes of Italian patients affected by musculoskeletal pain regarding CFs.
Methods: A national sample of Italian patients with musculoskeletal pain was recruited from 12 outpatients private physiotherapy clinics situated in different regions of Italy. An invitation to participate in an online survey was sent to patient presenting:
1) musculoskeletal pain;
2) 18-75 years;
3) valid e-mail account;
4) understanding of Italian language.
Survey Monkey software was used to deliver the survey. The questionnaire was a self-report of the behavior, beliefs and attitudes of patients towards the adoption of CFs in physical therapy practice. Data were analysed by descriptive statistics and frequencies to describe the actual number of respondents to each question.
Results: 1112 patients were invited and all participated in the survey (100 %). 575 participants were female (52%), 538 (48%) were male. The mean age was 41.67 ± 15.3 years (range 18-74 years). They believed that:
- specific CFs such as therapeutic alliance (49%) and information provided by physiotherapists (52%) could influence therapeutic outcomes;
- a real effect of CFs can occur in acute pain (57%), chronic pain (56%) and rheumatologic disorders (40%);
- the use of CF when it exerts beneficial psychological effects (77%) is considerable ethically acceptable;
- the use of CFs should be banned when it is based on deception (66%);
- therapeutic power of CF is explained through body-mind connections (59%).
Moreover they expressed the desire to be informed about the adoption of CFs during the clinical encounter (62%) and positively accept the adoption of CFs as addition to other physical therapy interventions to optimize clinical responses (62%).
Conclusion(s): Italian patients, affected by musculoskeletal disorders, mostly had positive attitudes towards the implementation of CFs associated with physiotherapy and considered their adoption ethically correct.
Implications: The positive patients' view towards the therapeutic use of CFs offers to the physiotherapy community of practice the opportunity to systematically enhance their adoption in clinical setting and stimulates to study their specific effects by randomized controlled trial.
Keywords: placebo effects, contextual factors, musculoskeletal pain
Funding acknowledgements: This work was unfunded
Topic: Pain & pain management; Musculoskeletal
Ethics approval required: Yes
Institution: University of Genova
Ethics committee: Liguria Clinical Experimental Ethics Committee
Ethics number: P.R.236REG2016, accepted on 19/07/2016
All authors, affiliations and abstracts have been published as submitted.
