File
Schoeb V1,2, Yip A3
1HES-SO University of Applied Sciences and Arts of Western Switzerland, HESAV - School of Health Sciences, Lausanne, Switzerland, 2Hong Kong Polytechnic University (PolyU), Rehabilitation Sciences, Hong Kong, Hong Kong, 3Queen Mary University, School of Languages, Linguistics and Film, London, United Kingdom
Background: When physiotherapists work with patients on their exercise program, their main task is to select approprite exercises to address muscle weaknesses or limitation in range of motions, to instruct them to patients and to ensure that exercises are performed correctly. Physiotherapists' communication skills are important in this context, not only to ensure that patients learn their exercises properly but also to accompagny patients in adhering to the recommended exercise regime. Good instruction is therefore essential for exercise performance and adherence. In addition, patient's engagement is key during exercise therapy. Even though the patient's participation related to their care has been advocated in the literature, there are multiple barriers to achieve optimal patient participation. Studies have identified factors related to patient-physiotherapist interactions that might have an impact on patient participation during exercise therapy.
Purpose: The objective of this qualitative study was to analyze patient-therapist interactions during exercise therapy and to analyze verbal and non-verbal resources deployed to engage patients in exercises.
Methods: Data were collected from two outpatient physiotherapy settings in Hong Kong. A total of 47 consultations involving six physiotherapists and sixteen patients were video-recorded. Conversation Analysis was adopted to examine the sequence and function of verbal and non-verbal aspects of the patient-physiotherapist communication. Conversation Analysis, a qualitative observational method, was able to identify how physiotherapists initiatiated the instruction of an exercise and how patients responded to these instructions, or how patients initiated turns to enuire about specific aspects of the instructions and prescriptions of exercises.
Results: Findings revealed that patients used both verbal and non-vocal resources to initiate actions during clinical encounters. Patients self-initiated their turns to express symptoms-related concerns, display (in)competence, seek confirmation or clarification, request information and provide additional information. In response, physiotherapists sometimes acknowledge these enquiries but did not always take subsequent actions in response to these initiatives. Regarding the patients' participation, five different interactional strategies were observed. Patients constructed their role as receivers, performers, minor contributors, major contributors or collaborators. The findings demonstrated that when patients' engagement were linked to the phase structure of exercises, it was mainly during the correction and consolidation phases where patient participation is enhanced.
Conclusion(s): This study identified interactional resources and strategies available for patients to participate during exercise therapy. Describing the fine details of patient-therapist interactions during exercise therapy help understand how language and bodily resources are used to construct patient participation collaboratively. A closer examination into the health professional-patient interaction during therapeutic interventions can shed light onto what communicative practices in rehabilitation sciences can be most effective.
Implications: Exercise therapy is a cornerstone of physiotherapy practice and knowing more about how patients and professionals collaborate during instruction and correction of exercise is highly relevant for practitioners. The strategies used by the patients as “major contributors” represented effective means for them to actively engage during physiotherapy sessions.
Keywords: Exercise therapy, patient participation, patient-physiotherapist interaction
Funding acknowledgements: This study was funded by the Department of Rehabilitation Sciences, Hong Kong Polytechnic University (Grant No 1-ZE4F)
Purpose: The objective of this qualitative study was to analyze patient-therapist interactions during exercise therapy and to analyze verbal and non-verbal resources deployed to engage patients in exercises.
Methods: Data were collected from two outpatient physiotherapy settings in Hong Kong. A total of 47 consultations involving six physiotherapists and sixteen patients were video-recorded. Conversation Analysis was adopted to examine the sequence and function of verbal and non-verbal aspects of the patient-physiotherapist communication. Conversation Analysis, a qualitative observational method, was able to identify how physiotherapists initiatiated the instruction of an exercise and how patients responded to these instructions, or how patients initiated turns to enuire about specific aspects of the instructions and prescriptions of exercises.
Results: Findings revealed that patients used both verbal and non-vocal resources to initiate actions during clinical encounters. Patients self-initiated their turns to express symptoms-related concerns, display (in)competence, seek confirmation or clarification, request information and provide additional information. In response, physiotherapists sometimes acknowledge these enquiries but did not always take subsequent actions in response to these initiatives. Regarding the patients' participation, five different interactional strategies were observed. Patients constructed their role as receivers, performers, minor contributors, major contributors or collaborators. The findings demonstrated that when patients' engagement were linked to the phase structure of exercises, it was mainly during the correction and consolidation phases where patient participation is enhanced.
Conclusion(s): This study identified interactional resources and strategies available for patients to participate during exercise therapy. Describing the fine details of patient-therapist interactions during exercise therapy help understand how language and bodily resources are used to construct patient participation collaboratively. A closer examination into the health professional-patient interaction during therapeutic interventions can shed light onto what communicative practices in rehabilitation sciences can be most effective.
Implications: Exercise therapy is a cornerstone of physiotherapy practice and knowing more about how patients and professionals collaborate during instruction and correction of exercise is highly relevant for practitioners. The strategies used by the patients as “major contributors” represented effective means for them to actively engage during physiotherapy sessions.
Keywords: Exercise therapy, patient participation, patient-physiotherapist interaction
Funding acknowledgements: This study was funded by the Department of Rehabilitation Sciences, Hong Kong Polytechnic University (Grant No 1-ZE4F)
Topic: Musculoskeletal; Service delivery/emerging roles; Professional practice: other
Ethics approval required: Yes
Institution: The Hong Kong Polytechnic University
Ethics committee: Hospital Authority Hong Kong West Cluster
Ethics number: No. HSEARS20150902001 (PolyU) and No. UW 15–626 (HA)
All authors, affiliations and abstracts have been published as submitted.
