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Holopainen R1, Piirainen A1, Karppinen J2,3, Linton SJ4, O'Sullivan P5,6
1University of Jyväskylä, Jyväskylä, Finland, 2Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland, 3Finnish Institute of Occupational Health, Oulu, Finland, 4Center for Health and Medical Psychology, School of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden, 5School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia, 6Bodylogic Physiotherapy, Perth, Australia
Background: Current clinical practice has not been effective in managing low back pain and attempts to change professionals' practice behavior towards a biopsychosocial approach, which is recommended by many guidelines, but which has had varied outcomes.
Purpose: The most effective way of implementing new approaches in physiotherapists' clinical practice remains unknown and one way to gain knowledge about this process is to explore physiotherapists' perceived benefits and barriers in changing their practice behavior. The aim of the present study, that was conducted alongside with a feasibility study exploring the implementation of the Cognitive Functional Therapy (CFT) approach into Finnish primary and occupational health care, was to explore physiotherapists' conceptions of changing their practice behavior after 4 to 6 days of CFT workshops.
Methods: Twenty-two physiotherapists that participated in CFT workshops were interviewed individually. The interviews were audio recorded and transcribed verbatim. A phenomenographic approach was used in analysing the results to explore qualitatively different ways of understanding the phenomenon of changing one's own practice behavior.
Results: Four themes were identified from the data: membership in the clinical community, the learning journey, transition of work and changing one's outlook on physiotherapy. These themes varied in four descriptive categories: recognizing difference of the new approach, the new approach challenges the own understanding, awakening to explore, commitment to the new approach and widening application of the new approach. The findings indicated that there were a number of critical aspects that enabled physiotherapists to change their practice behavior. These aspects were cognitive flexibility, ability to critically reflect on one's work and get out of one's comfort zone, being challenged, support from the clinical community and increased confidence, daring to be creative, cooperation and understanding the importance of continuous learning.
Conclusion(s): Participants reported a range of responses to the training, suggesting that for some the training was insufficient to support adequate change in their practice behavior. Physiotherapists reported that the CFT training intervention led them towards a more biopsychosocial understanding and care of patients with LBP. Being shaken at the workshop functioned as a driving force in changing one's practice behaviors. For some participants the change was more comprehensive than others, but all adopted at least some parts of CFT approach and reported changing their practice behavior.
Implications: In the future it will be important to test ways of maximizing the impact of training interventions on making successful changes in physiotherapists' practice behavior.The results of this study can be used in planning those programs.
Keywords: Biopsychosocial, Low back pain, Implementation
Funding acknowledgements: University of Jyväskylä
Purpose: The most effective way of implementing new approaches in physiotherapists' clinical practice remains unknown and one way to gain knowledge about this process is to explore physiotherapists' perceived benefits and barriers in changing their practice behavior. The aim of the present study, that was conducted alongside with a feasibility study exploring the implementation of the Cognitive Functional Therapy (CFT) approach into Finnish primary and occupational health care, was to explore physiotherapists' conceptions of changing their practice behavior after 4 to 6 days of CFT workshops.
Methods: Twenty-two physiotherapists that participated in CFT workshops were interviewed individually. The interviews were audio recorded and transcribed verbatim. A phenomenographic approach was used in analysing the results to explore qualitatively different ways of understanding the phenomenon of changing one's own practice behavior.
Results: Four themes were identified from the data: membership in the clinical community, the learning journey, transition of work and changing one's outlook on physiotherapy. These themes varied in four descriptive categories: recognizing difference of the new approach, the new approach challenges the own understanding, awakening to explore, commitment to the new approach and widening application of the new approach. The findings indicated that there were a number of critical aspects that enabled physiotherapists to change their practice behavior. These aspects were cognitive flexibility, ability to critically reflect on one's work and get out of one's comfort zone, being challenged, support from the clinical community and increased confidence, daring to be creative, cooperation and understanding the importance of continuous learning.
Conclusion(s): Participants reported a range of responses to the training, suggesting that for some the training was insufficient to support adequate change in their practice behavior. Physiotherapists reported that the CFT training intervention led them towards a more biopsychosocial understanding and care of patients with LBP. Being shaken at the workshop functioned as a driving force in changing one's practice behaviors. For some participants the change was more comprehensive than others, but all adopted at least some parts of CFT approach and reported changing their practice behavior.
Implications: In the future it will be important to test ways of maximizing the impact of training interventions on making successful changes in physiotherapists' practice behavior.The results of this study can be used in planning those programs.
Keywords: Biopsychosocial, Low back pain, Implementation
Funding acknowledgements: University of Jyväskylä
Topic: Education; Musculoskeletal: spine
Ethics approval required: Yes
Institution: -
Ethics committee: Northern Ostrobothnia Hospital District Ethics Committee
Ethics number: -
All authors, affiliations and abstracts have been published as submitted.
