Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
University of Humanistics, Utrecht, the Netherlands.
Braz J Phys Ther. 2023 Sep-Oct;27(5):100552. doi: 10.1016/j.bjpt.2023.100552. Epub 2023 Oct 5.
In physical therapy practice patients and therapists exchange their perspectives on musculoskeletal health problems and their meaning for both of them. However, literature indicates that physical therapists find it difficult to enquire about the patients' values during clinical encounters.
The aim of this study was to gain deeper insight into the perspectives of physical therapists about patient values.
Explorative qualitative focus group study.
Twenty-three physical therapists were interviewed in the Netherlands from March to May 2021. Two researchers analyzed the interviews and derived relevant codes. After an iterative process of comparing, analyzing, conceptualizing and discussing the codes, themes were identified through a thematic framework, illustrated with meaningful quotes.
Three major themes were identified: Humane, Tacit, and Responsive. It appeared that patient values play unconsciously a major role in daily practice and are associated with humanity, not technical or procedural aspects of the encounter. Responsive denotes that all values require interaction in which aligning with the individual patient forms the basis of treatment. Barriers for being responsive are identified as subthemes: Choices, Trust, Diverseness, and Boundaries.
The concept of patient values appeared to be implicit. The professional intuitively attunes as a fellow human being to values and expectations of the individual patient. This study contributes to finding a balance and mutual reinforcement of implicit and explicit knowledge. With all found experiences and insights the concept of patient values became more explicit in physical therapy to create a framework for education and research in the future.
在物理治疗实践中,患者和治疗师会就肌肉骨骼健康问题及其对双方的意义交换看法。然而,文献表明,物理治疗师在临床就诊时很难询问患者的价值观。
本研究旨在更深入地了解物理治疗师对患者价值观的看法。
探索性定性焦点小组研究。
2021 年 3 月至 5 月,在荷兰对 23 名物理治疗师进行了访谈。两名研究人员分析了访谈并得出相关代码。在对代码进行比较、分析、概念化和讨论的迭代过程之后,通过主题框架确定了主题,并通过有意义的引语进行了说明。
确定了三个主要主题:人性化、隐性和响应性。患者价值观在日常实践中无意识地发挥着重要作用,与人性而非相遇的技术或程序方面相关。响应性表示所有价值观都需要互动,与个体患者保持一致是治疗的基础。被确定为响应性障碍的子主题有:选择、信任、多样性和界限。
患者价值观的概念似乎是隐含的。专业人员作为人类伙伴,会本能地适应个体患者的价值观和期望。本研究有助于在隐性和显性知识之间找到平衡和相互加强。通过所有发现的经验和见解,患者价值观的概念在物理治疗中变得更加明确,为未来的教育和研究创造了一个框架。