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Stöckli J1, Schoeb V2
1Bern University of Applied Sciences, Stans, Switzerland, 2Haute Ecole de Santé Vaud – HESAV, HES-SO, Lausanne, Switzerland
Background: Adherence to recommendations and exercise programs is one of the most important foundations for the effectiveness of physiotherapeutic interventions. Today, it is also known that the relationship between patients and physiotherapists as well as their communication skills can have an effect on adherence and thus on therapeutic success. However, to date, we do not know how the patients and their physiotherapists collaborate during the instruction and execution of a home exercise program and how home exercise adherence is discussed in physiotherapy follow up sessions.
Purpose: The aim of this study was to analyze the interaction between patients and physiotherapists to identify practices that hinder or promote home exercise adherence.
Methods: Using ethnographic methodology, 87 patient-physiotherapist consultations were observed and video-recorded, and 17 inteviews were undertaken with patients and physiotherapists separately in Switzerland. The data was transcribed verbatim and analysed using thematic analysis.
Results: Five themes emerged from the data: activity structure, adherence as a non-issue, indirectly reviewed adherence, practitioner-centred communication model, and bio-medical focus.
Conclusion(s): Participation of patients depends on the quality of interaction with the physiotherapist. This comparative pilot study helps us to understand which aspects are important for the adherence of exercise programs in physiotherapy. The results can be integrated into education and training of health professionals to improve the quality of patient care.
Implications: Home exercise program (HEP) needs to be simple, individual, fit into daily routine and linked to patient's preferences and goal. Clear instruction, demonstration, practice and repetition enhance patient's confidence in doing their HEP and therefore improves adherence.
The adherence problem should be minimized through teaching, training, education, research and finally translating this knowledge into physiotherapy practice.
Keywords: Compliance, Communication, Ethnography
Funding acknowledgements: No funding
Purpose: The aim of this study was to analyze the interaction between patients and physiotherapists to identify practices that hinder or promote home exercise adherence.
Methods: Using ethnographic methodology, 87 patient-physiotherapist consultations were observed and video-recorded, and 17 inteviews were undertaken with patients and physiotherapists separately in Switzerland. The data was transcribed verbatim and analysed using thematic analysis.
Results: Five themes emerged from the data: activity structure, adherence as a non-issue, indirectly reviewed adherence, practitioner-centred communication model, and bio-medical focus.
Conclusion(s): Participation of patients depends on the quality of interaction with the physiotherapist. This comparative pilot study helps us to understand which aspects are important for the adherence of exercise programs in physiotherapy. The results can be integrated into education and training of health professionals to improve the quality of patient care.
Implications: Home exercise program (HEP) needs to be simple, individual, fit into daily routine and linked to patient's preferences and goal. Clear instruction, demonstration, practice and repetition enhance patient's confidence in doing their HEP and therefore improves adherence.
The adherence problem should be minimized through teaching, training, education, research and finally translating this knowledge into physiotherapy practice.
Keywords: Compliance, Communication, Ethnography
Funding acknowledgements: No funding
Topic: Musculoskeletal
Ethics approval required: Yes
Institution: Ethics Committee of Nordwest- und Zentralschweiz (EKNZ)
Ethics committee: Ethics Committee of Nordwest- und Zentralschweiz (EKNZ)
Ethics number: 2017 - 00981
All authors, affiliations and abstracts have been published as submitted.
