Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
University of Humanistic Studies, Utrecht, The Netherlands.
Physiother Res Int. 2021 Jan;26(1):e1877. doi: 10.1002/pri.1877. Epub 2020 Sep 11.
Physiotherapy is, like all healthcare professions, relational and value-laden. Patient-centred care, evidence-based practice and value-based practices are concepts in which patient values lie at the heart of high-quality healthcare practices. Nevertheless, physiotherapists have limited awareness of what patient values are in the physiotherapy encounter. The purpose of this study is to explore these patient values.
A qualitative study design using content analysis was used involving 17 adult participants with chronic or recurrent musculoskeletal pain. Data were collected during July 2015-July 2016 in three primary care physiotherapy facilities in Rotterdam, The Netherlands. Two researchers analysed the interviews and derived relevant codes from the data. After an iterative process of comparing, analysing, conceptualizing, and discussing the data, a pre-existing analytic framework was refined in which distinct values were delineated.
Emerging patient values were encompassed in three themes, each consisting of two to four elements: (1) values about oneself (uniqueness and autonomy), (2) values regarding actions of the professional (technically skilled professional, conscientious professional, compassionate professional, responsive professional) and (3) values regarding interactions between patients and the professionals (partnership and empowerment).
This study emphasizes the need for discussing patient values in the clinical encounter and helps physiotherapists to understand what deems to be important for patients with musculoskeletal pain in physiotherapy practice. The results of this study contribute to the existing body of knowledge of this important aspect of the quality of physiotherapy practice and may inspire clinicians and educators to actively implement patient values in clinical practice and the physiotherapy education.
物理治疗与所有医疗保健专业一样，是有联系的，且具有价值观。以患者为中心的护理、循证实践和基于价值的实践是将患者价值观置于高质量医疗保健实践核心的概念。然而，物理治疗师对物理治疗中患者价值观的认识有限。本研究旨在探讨这些患者价值观。
本研究采用定性研究设计，使用内容分析法，涉及 17 名患有慢性或复发性肌肉骨骼疼痛的成年参与者。数据于 2015 年 7 月至 2016 年 7 月在荷兰鹿特丹的三家初级保健物理治疗机构收集。两名研究人员分析了访谈并从数据中得出相关代码。在对数据进行比较、分析、概念化和讨论的迭代过程之后，对现有的分析框架进行了细化，其中明确了不同的价值观。
出现的患者价值观包含在三个主题中，每个主题包含两个到四个要素：（1）关于自身的价值观（独特性和自主性）；（2）关于专业人员行为的价值观（技术熟练的专业人员、认真负责的专业人员、富有同情心的专业人员、反应灵敏的专业人员）；（3）关于患者与专业人员之间互动的价值观（伙伴关系和赋权）。
本研究强调了在临床接触中讨论患者价值观的必要性，并帮助物理治疗师了解肌肉骨骼疼痛患者在物理治疗实践中认为什么是重要的。本研究的结果为物理治疗实践质量的这一重要方面的现有知识体系做出了贡献，并可能激发临床医生和教育工作者在临床实践和物理治疗教育中积极实施患者价值观。
