Patients' expectations of physiotherapists before and after an intensive chronic low back pain rehabilitation programme: a qualitative study based on semi-structured interviews and observations

Patient-therapist agreement on rehabilitation goals is central to meeting the expectations of patients following a chronic low back pain (CLBP) rehabilitation programme. Physiotherapists should be aware of the wide range of expectations that patients with CLBP have of them in terms of skills develop...

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Bibliographic Details
Published in:Disability and rehabilitation 2024-05, Vol.ahead-of-print (ahead-of-print), p.1-11
Main Authors: Pichonnaz, Claude, Ancey, Céline, Mbarga, Josiane, Foley, Rose-Anna
Format: Article
Language:English
Subjects:
Adult
chronic pain
Chronic Pain - psychology
Chronic Pain - rehabilitation
Expectation
Female
Humans
Interviews as Topic
low back pain
Low Back Pain - psychology
Low Back Pain - rehabilitation
Male
Middle Aged
Pain Measurement
patient perspective
Patient Satisfaction
Physical Therapists - psychology
Physical Therapy Modalities
physiotherapy
Qualitative Research
rehabilitation
Young Adult
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Summary:Patient-therapist agreement on rehabilitation goals is central to meeting the expectations of patients following a chronic low back pain (CLBP) rehabilitation programme. Physiotherapists should be aware of the wide range of expectations that patients with CLBP have of them in terms of skills development, relationship and outcome. The treatments expected by patients with CLBP were mostly compatible with scientific treatment recommendations. Since expectations are rarely expressed spontaneously during treatment sessions, physiotherapists should regularly enquire about them and their evolution in the course of rehabilitation. Following the programme, the patients' expectations had shifted from focusing on the physiotherapist to taking responsibility for self-management of the CLBP, although they had some doubt about their ability to achieve this. To investigate the expectations regarding physiotherapists of patients attending an interdisciplinary CLBP rehabilitation programme and the response to these expectations. A thematic analysis was conducted, based on interviews of working-age patients with CLBP and without significant comorbidities. Twenty patients participated (9 male, 11 female, aged 21-58 years; symptoms duration 4.3 ± 3.0 years; pain VAS 53 ± 21 mm). Patients expected to learn pain and activity management. Expected outcomes were a reduction of pain, increased well-being and a return to normality. A collaborative approach involving therapeutic and relational adaptation was expected. Despite divergences concerning emotional aspects, patients expected a large range of applied psychosocial skills. The programme met the expectations of most patients, especially when its goals matched those reported by the individuals. For most participants, the pain relief was below expectations. Active therapies were valued. After the programme, patients felt more ready to take responsibility for their back. The expectation of developing self-management skills was prevalent. Expected treatments were mostly compatible with recommendations. Expectations to resume activities and decrease pain were in line with the rehabilitation goals, although the expected reduction in pain was overestimated. Relational expectations converged towards patient-centred care.
ISSN:0963-8288
1464-5165
DOI:10.1080/09638288.2023.2205171