Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
Disabil Rehabil. 2022 Jul;44(14):3388-3399. doi: 10.1080/09638288.2020.1861116. Epub 2020 Dec 22.
To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT).
As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions.
The analysis revealed four descriptive categories: "hung out to dry," "stuck," "making sense and taking control," and "holistic approach to care and living," that varied based on six themes.
Although the participants accepted this approach to care well, there was significant variation in patients' conceptions. Restricted access to care within the healthcare system and a lack of social support led some of them to feel they had been left alone to suffer with their pain. On the other hand, based on the results of this study, positive experiences of physiotherapy and good collaboration with the physiotherapist, wider social support outside of physiotherapy, a better understanding of the multidimensional nature of pain and the acquisition of self-management skills were reported as positive aspects of undergoing physiotherapy that may be related to positive treatment outcomes.Implications for rehabilitationThe participants of this study saw undergoing physiotherapy delivered within biopsychosocial framework as different from their previous physiotherapy experiences and for some the process ended with feeling empty-handed and for others it could be a turning point in their lives.This study encourages the health care providers to create flexible care pathways and ongoing support for more vulnerable individuals so that they don't feel abandoned by the system.Professionals could also pay attention to building strong therapeutic alliance, help patients understand pain in biopsychosocial framework, take into consideration social support networks of the patients, and support patients toward effective self-management strategies.
探索接受过认知功能疗法（CFT）简短培训的芬兰初级保健物理治疗师提供的物理治疗的持续性腰痛（LBP）患者的概念。
作为在芬兰初级保健系统中管理 LBP 中探索 CFT 的可行性实施研究的一部分，我们在接受护理后采访了来自芬兰四个地理区域的九名患者。我们使用现象学方法来探索他们观念的变化。
分析揭示了四个描述性类别：“晾在一边”、“卡住”、“理解并控制”和“整体护理和生活方式”，这六个主题各不相同。
尽管参与者接受了这种护理方式，但患者的观念存在显著差异。医疗保健系统中护理机会有限且缺乏社会支持，导致他们中的一些人感到自己在痛苦中被孤立无援。另一方面，基于这项研究的结果，积极的物理治疗体验以及与物理治疗师的良好合作、物理治疗之外更广泛的社会支持、对疼痛多维性质的更好理解以及自我管理技能的获得被认为是接受物理治疗的积极方面，可能与积极的治疗结果有关。
这项研究的参与者认为，在生物心理社会框架内接受物理治疗与他们以前的物理治疗经验不同，对一些人来说，这个过程结束时感到两手空空，而对另一些人来说，这可能是他们生活的转折点。这项研究鼓励医疗保健提供者为更脆弱的个体创建灵活的护理途径和持续的支持，以防止他们感到被系统抛弃。专业人员还可以注意建立强大的治疗联盟，帮助患者在生物心理社会框架中理解疼痛，考虑患者的社会支持网络，并支持患者采取有效的自我管理策略。
