Galea Holmes Melissa N, Wileman Vari, McCracken Lance M, Critchley Duncan, March Marie K, Norton Sam, Moss-Morris Rona, Noonan Sandra, Barcellona Massimo, Godfrey Emma
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Hospital Campus, London, SE1 9RT, UK.
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Hospital Campus, London, SE1 9RT, UK; Department of Psychology, Uppsala University, Uppsala, 751 42, Sweden.
Physiotherapy. 2021 Sep;112:41-48. doi: 10.1016/j.physio.2020.12.004. Epub 2020 Dec 29.
Physiotherapy informed by Acceptance and Commitment Therapy (PACT) is a novel intervention that is related to improved disability and functioning in people with chronic lowback pain. This study explored physiotherapists experiences over time of the PACT training programme and intervention delivery.
A longitudinal qualitative study using semi-structured, in-depth, individual interviews at three time points was conducted.
A phenomenological approach underpinned the methods. Interviews followed topic-guides developed a priori. Transcribed interviews were coded inductively to generate themes. Data were member checked by participants and validated by two researchers.
Eight clinical physiotherapists from three secondary care centres in the United Kingdom (n = 5 female; age, 24 to 44 years; duration of practice, 3 to 14 years) were included.
Five themes emerged from the data. Experiential learning techniques were challenging but valued because they bridged theoretical principles and concepts with practice. Ongoing individual and group supervision was beneficial, but required tailoring and tapering. PACT delivery extended physiotherapy skills and practice, including techniques that acknowledged and addressed patient treatment expectations. With experience, participants desired greater flexibility and autonomy to tailor PACT delivery.
PACT training and delivery were acceptable to physiotherapists. Existing skills were developed and additional, applicable approaches were provided that addressed psychosocial and behavioural aspects of chronic low back pain.
基于接纳与承诺疗法的物理治疗（PACT）是一种新型干预措施，与改善慢性腰痛患者的残疾状况和功能有关。本研究探讨了物理治疗师在一段时间内参与PACT培训项目及实施干预的经历。
采用纵向定性研究，在三个时间点进行半结构化、深入的个人访谈。
该方法以现象学方法为基础。访谈遵循预先制定的主题指南。对转录的访谈进行归纳编码以生成主题。数据由参与者进行成员核对，并由两名研究人员进行验证。
纳入了来自英国三个二级医疗中心的八名临床物理治疗师（n = 5名女性；年龄24至44岁；执业年限3至14年）。
数据中出现了五个主题。体验式学习技巧具有挑战性，但很有价值，因为它们将理论原则和概念与实践联系起来。持续的个人和小组督导是有益的，但需要进行调整和缩减。实施PACT扩展了物理治疗技能和实践，包括承认并满足患者治疗期望的技巧。随着经验的积累，参与者希望在实施PACT时有更大的灵活性和自主权。
物理治疗师接受PACT培训和实施。现有的技能得到了发展，并提供了额外的适用方法，以解决慢性腰痛的心理社会和行为方面的问题。
