Reddington Michael, Baxter Susan, Walters Stephen J, Cole Ashley
Therapy Services Outpatient Department, Northern General Hospital, Herries Road, Sheffield S5 7AU, United Kingdom.
Section of Public Health, ScHARR, University of Sheffield, 30 Regents Court, Sheffield S1 4DA, United Kingdom.
Physiotherapy. 2022 Jun;115:102-110. doi: 10.1016/j.physio.2022.01.003. Epub 2022 Jan 31.
Physiotherapy is often utilised in the management of sciatica and yet little research has been undertaken to examine patient expectations and experiences of physiotherapy and its timing. This study reports patient expectations and experiences of accelerated access to physiotherapy for sciatica.
SETTING & PARTICIPANTS: Participants with clinically diagnosed sciatica (n=33) were recruited for individual interviews (n=46) from 14 National Health Service (NHS) primary care general practices, and one physiotherapy service provider in the same city in England.
This was a nested qualitative study within a pilot randomised controlled trial evaluating accelerated access to physiotherapy for sciatica. Interviews with consenting participants were undertaken with some participants prior to randomisation and again after completion of physiotherapy (n=13), some before treatment commencement (n=7) and others only after cessation of treatment (n=13). All interviews were audio recorded and thematically analysed.
Three themes emerged from the interviews: participants' expectations of physiotherapy, with negative expectations of physiotherapy being associated with experiences of previous unhelpful physiotherapy. Secondly, the perceived therapeutic value of accelerated physiotherapy in managing sciatica and preventing physical and psychological deterioration. Finally, the value of a personalised approach, with a physiotherapist who actively listened in partnership, and who provided a bespoke multimodal regimen.
Findings from this study suggest that accelerated access to physiotherapy has value in terms of aiding perceived recovery and/or halting further physical and psychological decline. An individualised patient approach alongside accelerated access to physiotherapy should be considered for patients with sciatica.
物理治疗常用于坐骨神经痛的管理，但很少有研究探讨患者对物理治疗的期望、体验及其时机。本研究报告了患者对坐骨神经痛加速获得物理治疗的期望和体验。
从英国同一城市的14家国民健康服务（NHS）初级保健全科诊所和一家物理治疗服务提供商中招募了临床诊断为坐骨神经痛的参与者（n = 33）进行个人访谈（n = 46）。
这是一项嵌套在评估坐骨神经痛加速获得物理治疗的试点随机对照试验中的定性研究。对同意参与的参与者进行访谈，一些参与者在随机分组前进行，在物理治疗完成后再次进行（n = 13），一些在治疗开始前进行（n = 7），其他仅在治疗停止后进行（n = 13）。所有访谈均进行录音并进行主题分析。
访谈中出现了三个主题：参与者对物理治疗的期望，对物理治疗的负面期望与之前无益的物理治疗体验相关。其次，加速物理治疗在管理坐骨神经痛和预防身体及心理恶化方面的感知治疗价值。最后，个性化方法的价值，即有一位积极倾听、合作并提供定制多模式方案的物理治疗师。
本研究结果表明，加速获得物理治疗在帮助感知恢复和/或阻止进一步身体和心理衰退方面具有价值。对于坐骨神经痛患者，应考虑采用个性化患者方法并加速获得物理治疗。
