Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions

Carol McCrum, Elizabeth Bryant, Shemane Murtagh, Lisa Hodgson, Guy Canby, Laura Finucane, Christopher Mercer, Toby Smith, A. Moore

Research output: Contribution to conferenceAbstractResearch

Abstract

Relevance Research shows that the expectations a patient brings to treatment have important influences on the clinical relationship, experiences of treatment, the treatment process, outcomes and satisfaction with care. This influence means that patients’ expectations are important for physiotherapists, service providers and researchers to take into account in approaches to care and treatment evaluations. Research highlights the need for a better understanding of expectations of physiotherapy treatment for Msk problems to enable more effective, high quality and cost-beneficial care. Purpose The aim of this qualitative study was to explore prospective responses to an open comment item on patients’ expectations of their physiotherapy treatment that was nested within a larger research project developing and validating the Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM). Methods/Analysis The BmPROM is a generic patient self-report outcome measure developed to evaluate the effectiveness of physiotherapy treatment for musculoskeletal conditions. A validity and reliability study was undertaken with patients newly referred into five NHS physiotherapy outpatient departments in SE England. The outcome tool has open-comment items, which included a pre-treatment invitation to provide expectations of their physiotherapy treatment. A thematic analysis was undertaken of the expectations expressed to gain insights for physiotherapy practice and patient care. Results Analysis was undertaken of 563 expectations of physiotherapy treatment expressed from 224 participants (mean 50.7yrs [17-88yrs]; 60% female) experiencing a range of Msk conditions (Lower limb:30%, Upper limb:25%, Spine:28%, Other/multiple sites:17%). Five key themes were identified. Three themes were outcome-related and desired effects of treatment; Relieving symptoms, predominately pain relief; Regaining and maintaining physical abilities and function; and Improving psychological well-being by enabling coping, confidence and control. Theme four was process-related; Explanation, advice and education, where physiotherapy was seen as a resource to acquire better knowledge, skills and strategies to support resolution, management or prevention. The final theme involved recovery expectations conveyed within responses; Problem resolution and responsibility, where responses implied an expectation of a cure or one of problem management and control. Discussion and conclusions The findings provide an understanding of domains considered important or appropriate by patients when seeking care for Msk problems. The themes show overlap with studies using retrospective explorations and surveys of treatment expectations, and research on outcomes considered important to evaluate within Msk PROMs. The study has also shown that a written method of eliciting expectations can be a valuable clinical tool for use to support discussions concerning treatment aims, strategies, desired outcomes and responsibilities. These communication processes are also likely to be integral to achieving the qualities in the therapist and clinical encounters considered important to patients, of feeling listened to, consulted with and respected, and associated with satisfaction with physiotherapy and features of patient-centred care. Impact and implications Healthcare is changing as evidence-informed practice and cost-benefit drivers influence what and how care is provided. Shifts from traditional understandings about Msk problems and their management makes exploring and addressing patients’ expectations particularly important. Developing ways to support appropriate expectations of physiotherapy treatment remains an important endeavour that is integral to its effectiveness and demonstrating its value.
Original languageEnglish
Pages0-0
Number of pages1
DOIs
Publication statusPublished - 10 Nov 2016
Event4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT) - Liverpool, 11-12 November 2016
Duration: 10 Nov 2016 → …

Conference

Conference4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT)
Period10/11/16 → …

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Therapeutics
Research
Outcome Assessment (Health Care)
Patient-Centered Care
Aptitude
Physical Therapists
Reproducibility of Results
Upper Extremity
England
Self Report
Cost-Benefit Analysis
Lower Extremity
Patient Care
Emotions
Spine
Outpatients
Retrospective Studies
Communication
Research Personnel
Psychology

Bibliographical note

© 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Cite this

McCrum, C., Bryant, E., Murtagh, S., Hodgson, L., Canby, G., Finucane, L., ... Moore, A. (2016). Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions. 0-0. Abstract from 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT), . https://doi.org/10.1016/j.physio.2016.10.032
McCrum, Carol ; Bryant, Elizabeth ; Murtagh, Shemane ; Hodgson, Lisa ; Canby, Guy ; Finucane, Laura ; Mercer, Christopher ; Smith, Toby ; Moore, A. / Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions. Abstract from 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT), .1 p.
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abstract = "Relevance Research shows that the expectations a patient brings to treatment have important influences on the clinical relationship, experiences of treatment, the treatment process, outcomes and satisfaction with care. This influence means that patients’ expectations are important for physiotherapists, service providers and researchers to take into account in approaches to care and treatment evaluations. Research highlights the need for a better understanding of expectations of physiotherapy treatment for Msk problems to enable more effective, high quality and cost-beneficial care. Purpose The aim of this qualitative study was to explore prospective responses to an open comment item on patients’ expectations of their physiotherapy treatment that was nested within a larger research project developing and validating the Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM). Methods/Analysis The BmPROM is a generic patient self-report outcome measure developed to evaluate the effectiveness of physiotherapy treatment for musculoskeletal conditions. A validity and reliability study was undertaken with patients newly referred into five NHS physiotherapy outpatient departments in SE England. The outcome tool has open-comment items, which included a pre-treatment invitation to provide expectations of their physiotherapy treatment. A thematic analysis was undertaken of the expectations expressed to gain insights for physiotherapy practice and patient care. Results Analysis was undertaken of 563 expectations of physiotherapy treatment expressed from 224 participants (mean 50.7yrs [17-88yrs]; 60{\%} female) experiencing a range of Msk conditions (Lower limb:30{\%}, Upper limb:25{\%}, Spine:28{\%}, Other/multiple sites:17{\%}). Five key themes were identified. Three themes were outcome-related and desired effects of treatment; Relieving symptoms, predominately pain relief; Regaining and maintaining physical abilities and function; and Improving psychological well-being by enabling coping, confidence and control. Theme four was process-related; Explanation, advice and education, where physiotherapy was seen as a resource to acquire better knowledge, skills and strategies to support resolution, management or prevention. The final theme involved recovery expectations conveyed within responses; Problem resolution and responsibility, where responses implied an expectation of a cure or one of problem management and control. Discussion and conclusions The findings provide an understanding of domains considered important or appropriate by patients when seeking care for Msk problems. The themes show overlap with studies using retrospective explorations and surveys of treatment expectations, and research on outcomes considered important to evaluate within Msk PROMs. The study has also shown that a written method of eliciting expectations can be a valuable clinical tool for use to support discussions concerning treatment aims, strategies, desired outcomes and responsibilities. These communication processes are also likely to be integral to achieving the qualities in the therapist and clinical encounters considered important to patients, of feeling listened to, consulted with and respected, and associated with satisfaction with physiotherapy and features of patient-centred care. Impact and implications Healthcare is changing as evidence-informed practice and cost-benefit drivers influence what and how care is provided. Shifts from traditional understandings about Msk problems and their management makes exploring and addressing patients’ expectations particularly important. Developing ways to support appropriate expectations of physiotherapy treatment remains an important endeavour that is integral to its effectiveness and demonstrating its value.",
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McCrum, C, Bryant, E, Murtagh, S, Hodgson, L, Canby, G, Finucane, L, Mercer, C, Smith, T & Moore, A 2016, 'Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions' 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT), 10/11/16, pp. 0-0. https://doi.org/10.1016/j.physio.2016.10.032

Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions. / McCrum, Carol; Bryant, Elizabeth; Murtagh, Shemane; Hodgson, Lisa; Canby, Guy; Finucane, Laura; Mercer, Christopher; Smith, Toby; Moore, A.

2016. 0-0 Abstract from 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT), .

Research output: Contribution to conferenceAbstractResearch

TY - CONF

T1 - Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions

AU - McCrum, Carol

AU - Bryant, Elizabeth

AU - Murtagh, Shemane

AU - Hodgson, Lisa

AU - Canby, Guy

AU - Finucane, Laura

AU - Mercer, Christopher

AU - Smith, Toby

AU - Moore, A.

N1 - © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2016/11/10

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N2 - Relevance Research shows that the expectations a patient brings to treatment have important influences on the clinical relationship, experiences of treatment, the treatment process, outcomes and satisfaction with care. This influence means that patients’ expectations are important for physiotherapists, service providers and researchers to take into account in approaches to care and treatment evaluations. Research highlights the need for a better understanding of expectations of physiotherapy treatment for Msk problems to enable more effective, high quality and cost-beneficial care. Purpose The aim of this qualitative study was to explore prospective responses to an open comment item on patients’ expectations of their physiotherapy treatment that was nested within a larger research project developing and validating the Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM). Methods/Analysis The BmPROM is a generic patient self-report outcome measure developed to evaluate the effectiveness of physiotherapy treatment for musculoskeletal conditions. A validity and reliability study was undertaken with patients newly referred into five NHS physiotherapy outpatient departments in SE England. The outcome tool has open-comment items, which included a pre-treatment invitation to provide expectations of their physiotherapy treatment. A thematic analysis was undertaken of the expectations expressed to gain insights for physiotherapy practice and patient care. Results Analysis was undertaken of 563 expectations of physiotherapy treatment expressed from 224 participants (mean 50.7yrs [17-88yrs]; 60% female) experiencing a range of Msk conditions (Lower limb:30%, Upper limb:25%, Spine:28%, Other/multiple sites:17%). Five key themes were identified. Three themes were outcome-related and desired effects of treatment; Relieving symptoms, predominately pain relief; Regaining and maintaining physical abilities and function; and Improving psychological well-being by enabling coping, confidence and control. Theme four was process-related; Explanation, advice and education, where physiotherapy was seen as a resource to acquire better knowledge, skills and strategies to support resolution, management or prevention. The final theme involved recovery expectations conveyed within responses; Problem resolution and responsibility, where responses implied an expectation of a cure or one of problem management and control. Discussion and conclusions The findings provide an understanding of domains considered important or appropriate by patients when seeking care for Msk problems. The themes show overlap with studies using retrospective explorations and surveys of treatment expectations, and research on outcomes considered important to evaluate within Msk PROMs. The study has also shown that a written method of eliciting expectations can be a valuable clinical tool for use to support discussions concerning treatment aims, strategies, desired outcomes and responsibilities. These communication processes are also likely to be integral to achieving the qualities in the therapist and clinical encounters considered important to patients, of feeling listened to, consulted with and respected, and associated with satisfaction with physiotherapy and features of patient-centred care. Impact and implications Healthcare is changing as evidence-informed practice and cost-benefit drivers influence what and how care is provided. Shifts from traditional understandings about Msk problems and their management makes exploring and addressing patients’ expectations particularly important. Developing ways to support appropriate expectations of physiotherapy treatment remains an important endeavour that is integral to its effectiveness and demonstrating its value.

AB - Relevance Research shows that the expectations a patient brings to treatment have important influences on the clinical relationship, experiences of treatment, the treatment process, outcomes and satisfaction with care. This influence means that patients’ expectations are important for physiotherapists, service providers and researchers to take into account in approaches to care and treatment evaluations. Research highlights the need for a better understanding of expectations of physiotherapy treatment for Msk problems to enable more effective, high quality and cost-beneficial care. Purpose The aim of this qualitative study was to explore prospective responses to an open comment item on patients’ expectations of their physiotherapy treatment that was nested within a larger research project developing and validating the Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM). Methods/Analysis The BmPROM is a generic patient self-report outcome measure developed to evaluate the effectiveness of physiotherapy treatment for musculoskeletal conditions. A validity and reliability study was undertaken with patients newly referred into five NHS physiotherapy outpatient departments in SE England. The outcome tool has open-comment items, which included a pre-treatment invitation to provide expectations of their physiotherapy treatment. A thematic analysis was undertaken of the expectations expressed to gain insights for physiotherapy practice and patient care. Results Analysis was undertaken of 563 expectations of physiotherapy treatment expressed from 224 participants (mean 50.7yrs [17-88yrs]; 60% female) experiencing a range of Msk conditions (Lower limb:30%, Upper limb:25%, Spine:28%, Other/multiple sites:17%). Five key themes were identified. Three themes were outcome-related and desired effects of treatment; Relieving symptoms, predominately pain relief; Regaining and maintaining physical abilities and function; and Improving psychological well-being by enabling coping, confidence and control. Theme four was process-related; Explanation, advice and education, where physiotherapy was seen as a resource to acquire better knowledge, skills and strategies to support resolution, management or prevention. The final theme involved recovery expectations conveyed within responses; Problem resolution and responsibility, where responses implied an expectation of a cure or one of problem management and control. Discussion and conclusions The findings provide an understanding of domains considered important or appropriate by patients when seeking care for Msk problems. The themes show overlap with studies using retrospective explorations and surveys of treatment expectations, and research on outcomes considered important to evaluate within Msk PROMs. The study has also shown that a written method of eliciting expectations can be a valuable clinical tool for use to support discussions concerning treatment aims, strategies, desired outcomes and responsibilities. These communication processes are also likely to be integral to achieving the qualities in the therapist and clinical encounters considered important to patients, of feeling listened to, consulted with and respected, and associated with satisfaction with physiotherapy and features of patient-centred care. Impact and implications Healthcare is changing as evidence-informed practice and cost-benefit drivers influence what and how care is provided. Shifts from traditional understandings about Msk problems and their management makes exploring and addressing patients’ expectations particularly important. Developing ways to support appropriate expectations of physiotherapy treatment remains an important endeavour that is integral to its effectiveness and demonstrating its value.

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McCrum C, Bryant E, Murtagh S, Hodgson L, Canby G, Finucane L et al. Patients’ Expectations of Physiotherapy Treatment for Musculoskeletal Conditions. 2016. Abstract from 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT), . https://doi.org/10.1016/j.physio.2016.10.032