Arthritis Care & Research · 2017 · 44 citations · 28 references
MedicineRehabilitation MedicineMusculoskeletal RehabilitationPhysical TherapyRehabilitationArthritis RehabilitationExercise RehabilitationExercise TherapyKnee RehabilitationOrthopedic Physical TherapyPhysical RehabilitationAudit And FeedbackClinical Audit FeedbackPerson-centered RehabilitationPerson-centered TheoryPhysical Therapy RehabilitationSemi-structured InterviewsSkills PracticeTraining
OBJECTIVE: To explore physical therapists' experiences with, and the impacts of, a training program in person-centered practice to support exercise adherence in people with knee osteoarthritis. METHODS: This was a qualitative case study using semi-structured interviews, nested within a clinical trial. Eight Australian physical therapists were interviewed before, and after, training in person-centered practice for people with knee osteoarthritis. Training involved a 2-day workshop, skills practice, and audit of 8 consultations with 4 patients (per therapist), and a final single-day workshop for audit feedback and consolidation. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were thematically analyzed. RESULTS: Three pretraining themes arose regarding usual communication style, definitions of person-centered care, and sharing exercise adherence responsibility. Three themes related to the training experience emerged: learning a new language, challenging conceptions of practice, and putting it into practice. Post-training, 3 themes arose regarding new knowledge deepening understanding of person-centered care, changing beliefs about sharing responsibilities, and changed conceptions of role. CONCLUSION: Although physical therapists found training overwhelming initially as they realized the limitations of their current knowledge and clinical practice, they felt more confident and able to provide person-centered care to people with knee osteoarthritis by the end of training. Training in structured person-centered methodology that provides opportunity for skills practice with patients using a restructured consultation framework can change physical therapists' beliefs about their roles when managing patients with osteoarthritis and positively impact their clinical practice.
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