Gretland A1, Bergvik S2
1UiT The Arctic University of Norway, Institute of Health and Care Sciences, Tromsø, Norway, 2UiT The Arctic University of Norway, Institute of Psychology, Tromsø, Norway
Background: Patients presenting subjective health complaints (SHC) are poorly understood in biomedicine, and the term "no objective findings" leaves the patients with medically unexplained symptoms. However, research indicate that examined by physiotherapists specialized in Norwegian Psychomotor Physiotherapy, the patients in question commonly deviate significantly from healthy people regarding clinical findings in posture, respiration, movements and muscles
Purpose: Our study aims at knowledge on how a physiotherapist and her patient act to enlighten the patient's pain problem(s), and to examine the information provided of relevance to the patient's health problems.
Methods: Interaction analyzes based on a video recording were used to explore a first clinical meeting, where a diagnostic enterprise was created through talk and physical interaction. Detailed empirical data were analyzed and put into perspective by means of empiric driven theory.
Results: The session lasted for about 60 minutes, including an initial conversation, an examination of the entire body and a closing conversation. The physiotherapist looked for the patient's habitual posture and movements, how various movements started and spread throughout the body, how the patient yielded to or resisted gravity, how she let the therapist move her, how she reacted to changes in movement and body posture in different positions and so on. The therapist invited to short verbal dialogs, concerning the patient's body awareness, her attribution of meaning to perceived bodily phenomena, and whether the patient recognized these phenomena from her daily life. The physiotherapist followed a known survey form, but invited the patient to active participation in words and actions, meaning that both parties contributed to an evolution of information on the patient's life and health problems. Whether the communicative channel was talk or bodily interaction, both parties participated in a dynamic process, opening for intersubjectivity at several levels. A main finding was that they both felt and said that the patient was unable to relax fully. Asked about it, the patient attributed her long-lasting tensions to needs of control, of maintaining her self-image, and of living up to norms of bodily comportment: Stand tall, be straight, keep ahead were prominent themes amongst female members of her family. We discuss these findings enlightened by theory on habitual bodily agency as incorporation of tacit and explicit gendered social practices. We also enlighten possible connections between stressful habitual patterns of bodily agency and the patient´s health problems.
Conclusion(s): The study supports research indicating that inter-subjective clinical interaction may add valuable information on bodily functioning, connected to and embedded in the patient's everyday, social life. It adds knowledge on how bodily dysfunctions and pain may be specifically related to incorporated social norms on bodily agency.
Implications: A social perspective on bodily agency can be relevant to physiotherapist´s assisting patients in helping them to find less straining ways of body comportment to reduce SHC. Knowing that the vast majority of patients with SHC are women, we request further reseach to enlighten bodily agency as a gendered, social phenomena, and investigate it's relevance to SHC.
Keywords: Interaction, social body, therapy research
Funding acknowledgements: The initial phase of this study was economically supported by The Norwegian Fund for Post-Graduate Training in Physiotherapy.
Purpose: Our study aims at knowledge on how a physiotherapist and her patient act to enlighten the patient's pain problem(s), and to examine the information provided of relevance to the patient's health problems.
Methods: Interaction analyzes based on a video recording were used to explore a first clinical meeting, where a diagnostic enterprise was created through talk and physical interaction. Detailed empirical data were analyzed and put into perspective by means of empiric driven theory.
Results: The session lasted for about 60 minutes, including an initial conversation, an examination of the entire body and a closing conversation. The physiotherapist looked for the patient's habitual posture and movements, how various movements started and spread throughout the body, how the patient yielded to or resisted gravity, how she let the therapist move her, how she reacted to changes in movement and body posture in different positions and so on. The therapist invited to short verbal dialogs, concerning the patient's body awareness, her attribution of meaning to perceived bodily phenomena, and whether the patient recognized these phenomena from her daily life. The physiotherapist followed a known survey form, but invited the patient to active participation in words and actions, meaning that both parties contributed to an evolution of information on the patient's life and health problems. Whether the communicative channel was talk or bodily interaction, both parties participated in a dynamic process, opening for intersubjectivity at several levels. A main finding was that they both felt and said that the patient was unable to relax fully. Asked about it, the patient attributed her long-lasting tensions to needs of control, of maintaining her self-image, and of living up to norms of bodily comportment: Stand tall, be straight, keep ahead were prominent themes amongst female members of her family. We discuss these findings enlightened by theory on habitual bodily agency as incorporation of tacit and explicit gendered social practices. We also enlighten possible connections between stressful habitual patterns of bodily agency and the patient´s health problems.
Conclusion(s): The study supports research indicating that inter-subjective clinical interaction may add valuable information on bodily functioning, connected to and embedded in the patient's everyday, social life. It adds knowledge on how bodily dysfunctions and pain may be specifically related to incorporated social norms on bodily agency.
Implications: A social perspective on bodily agency can be relevant to physiotherapist´s assisting patients in helping them to find less straining ways of body comportment to reduce SHC. Knowing that the vast majority of patients with SHC are women, we request further reseach to enlighten bodily agency as a gendered, social phenomena, and investigate it's relevance to SHC.
Keywords: Interaction, social body, therapy research
Funding acknowledgements: The initial phase of this study was economically supported by The Norwegian Fund for Post-Graduate Training in Physiotherapy.
Topic: Primary health care
Ethics approval required: Yes
Institution: The Norwegian National Research Ethics Commitees
Ethics committee: Regional committee for medical and health care research northern Nor
Ethics number: 2010/2370
All authors, affiliations and abstracts have been published as submitted.
