File
Donlan P1
1Northeastern University, Physical Therapy, Movement, and Rehabilitation Sciences, Boston, United States
Background: Physical therapy (PT) treatment strives to improve well-being and quality of life physically, psychologically, and socially.1 With increasing recognition of PT as a biopsychosocial discipline, it is important to focus on patient needs and viewpoints and gain insight into how patients experience PT intervention, so that optimal care and outcomes can be achieved. 2,3 This is particularly significant when treating patients with chronic pain, who interact with physical therapists as part of interdisciplinary healthcare teams that emphasize self-management approaches to their conditions. 4
Purpose: The purpose of this report is to explore how patients with chronic pain experience PT, so that physical therapists understand the impact of their interventions in a way that allows them to positively influence the course and outcome of patient care.
Methods: To advance understanding of the patient perspective, a preliminary metasynthesis of qualitative research was performed. Qualitative approaches yield data that gives depth and context that standardized measures cannot offer.3 A metasynthesis systematically identifies, examines, compares, interprets, and synthesizes findings from multiple published qualitative studies, in order to arrive at new interpretations that prompt novel insights.5 A search of databases including CINAHL, MEDLIN, PsychINFO, and Education Research Complete was conducted so that appropriate studies could be identified. Subsequent to a review of the literature, data was pooled, and relevant overarching themes were created. Seven studies were deemed appropriate, based on relevance to the purpose of this report, as well as qualitative rigor.
Results: With respect to the purpose of this project, a metasynthesis revealed the following overarching themes:
1. Achieving wellness through individualized care,
a. Understanding factors that contribute to pain, and
3. Empowerment through positive relationships.
Major themes in individual studies indicate that patients with chronic pain value treatment approaches that emphasize decision making and active participation based upon individual needs and preferences. Additionally, participants experienced physical therapy as a means for understanding how body awareness, stress, and personal beliefs contribute to pain. Further, a strong therapeutic alliance, fostered by trust and professionalism, helped patients to gain confidence in their ability to manage pain.
Conclusion(s): This preliminary metasynthesis indicates that PT interventions contribute to pain management both biomedically and psychosocially, with compelling evidence that there is a strong link between psychosocial factors and favorable treatment outcomes. To gain further insight into this topic, a more comprehensive synthesis of scholarship that includes qualitative portions of mixed methods studies may be warranted.
Implications: In light of this evidence, clinicians should emphasize a biopsychosocial approach to physical therapy intervention by looking at how health related positive behavior change strategies can be integrated into a plan of care, and how PT sessions can be structured to incorporate a mind-body approach to treatment. Further, therapists may benefit from professional development that is focused on the delivery of relationship centered care, or care that moves beyond the patient centered process to focus on how practitioners and patients relate to each other. 6
Keywords: metasynthesis, patient experience, physical therapy
Funding acknowledgements: None.
Purpose: The purpose of this report is to explore how patients with chronic pain experience PT, so that physical therapists understand the impact of their interventions in a way that allows them to positively influence the course and outcome of patient care.
Methods: To advance understanding of the patient perspective, a preliminary metasynthesis of qualitative research was performed. Qualitative approaches yield data that gives depth and context that standardized measures cannot offer.3 A metasynthesis systematically identifies, examines, compares, interprets, and synthesizes findings from multiple published qualitative studies, in order to arrive at new interpretations that prompt novel insights.5 A search of databases including CINAHL, MEDLIN, PsychINFO, and Education Research Complete was conducted so that appropriate studies could be identified. Subsequent to a review of the literature, data was pooled, and relevant overarching themes were created. Seven studies were deemed appropriate, based on relevance to the purpose of this report, as well as qualitative rigor.
Results: With respect to the purpose of this project, a metasynthesis revealed the following overarching themes:
1. Achieving wellness through individualized care,
a. Understanding factors that contribute to pain, and
3. Empowerment through positive relationships.
Major themes in individual studies indicate that patients with chronic pain value treatment approaches that emphasize decision making and active participation based upon individual needs and preferences. Additionally, participants experienced physical therapy as a means for understanding how body awareness, stress, and personal beliefs contribute to pain. Further, a strong therapeutic alliance, fostered by trust and professionalism, helped patients to gain confidence in their ability to manage pain.
Conclusion(s): This preliminary metasynthesis indicates that PT interventions contribute to pain management both biomedically and psychosocially, with compelling evidence that there is a strong link between psychosocial factors and favorable treatment outcomes. To gain further insight into this topic, a more comprehensive synthesis of scholarship that includes qualitative portions of mixed methods studies may be warranted.
Implications: In light of this evidence, clinicians should emphasize a biopsychosocial approach to physical therapy intervention by looking at how health related positive behavior change strategies can be integrated into a plan of care, and how PT sessions can be structured to incorporate a mind-body approach to treatment. Further, therapists may benefit from professional development that is focused on the delivery of relationship centered care, or care that moves beyond the patient centered process to focus on how practitioners and patients relate to each other. 6
Keywords: metasynthesis, patient experience, physical therapy
Funding acknowledgements: None.
Topic: Pain & pain management; Professional issues
Ethics approval required: No
Institution: n/a
Ethics committee: n/a
Reason not required: no new data collected for metasynthesis
All authors, affiliations and abstracts have been published as submitted.
