Malta ICOM Educational, Santa Venera, Malta.
School of Physiotherapy, University of Verona, Via Bengasi 4, 37134, Verona, Italy; Department of Physiotherapy, Faculty of Sport Sciences, Musculoskeletal Pain and Motor Control Research Group, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain.
Musculoskelet Sci Pract. 2024 Oct;73:103164. doi: 10.1016/j.msksp.2024.103164. Epub 2024 Aug 14.
Person-centred care underscores the therapeutic alliance (TA) as fundamental, fostering positive treatment outcomes through collaborative patient-clinician interactions. Biobehavioural synchrony within the TA, essential for effective care, reflects an adaptive process where organisms align responses during interactions. Enactivism and active inference provide profound insights into human perception, reshaping musculoskeletal care understanding. Touch and verbal communication, integral to the TA, foster synchrony and alignment of personal beliefs.
This study aimed to identify the tools used by manual therapists in musculoskeletal care to establish a TA with patients. Furthermore, it endeavours to evaluate the alignment of these strategies with current literature and their correlation with biobehavioural synchrony, enactivism, and the role of touch in active inference.
The methodology followed rigorous qualitative research principles, particularly Grounded Theory and interpretative-constructivist principles, conducting eleven semi-structured interviews with open-ended questions.
The core category identified in the study is elucidated as follows: "Interwoven Connection: The Fabric of Therapeutic Synchrony." The interviews unveiled three main categories, each comprising sub-categories: (1) Creating a meaningful dialogue; (2) Promoting active patient participation; (3) Synchronisation.
Fostering meaningful dialogue, patient involvement, and therapeutic synchrony is crucial for a robust therapeutic alliance in musculoskeletal care. This underscores the importance of establishing a deep connection between clinicians and patients, central to effective person-centred care. Clinicians must prioritise two-way communication, empathy, and patient collaboration in defining personalised goals. Emphasizing touch and seeking patient feedback are also pivotal. Further research is needed to explore these elements and their impact.
以人为中心的护理强调治疗联盟（therapeutic alliance，TA）至关重要，通过医患协作互动促进积极的治疗结果。治疗联盟中的生物行为同步对于有效的护理至关重要，它反映了一种适应过程，即在互动中生物体协调反应。能动性和主动推断为人类感知提供了深刻的见解，重塑了肌肉骨骼护理的理解。触摸和言语交流是 TA 的重要组成部分，促进了同步和个人信念的协调。
本研究旨在确定肌肉骨骼护理中的手法治疗师用于与患者建立 TA 的工具。此外，还努力评估这些策略与当前文献的一致性，以及它们与生物行为同步、能动性以及触摸在主动推断中的作用的相关性。
该方法遵循严格的定性研究原则，特别是扎根理论和解释性建构主义原则，对 11 名患者进行了半结构式访谈，采用开放式问题。
研究中确定的核心类别如下：“交织的联系：治疗同步的结构”。访谈揭示了三个主要类别，每个类别都包含子类别：（1）建立有意义的对话；（2）促进积极的患者参与；（3）同步。
在肌肉骨骼护理中促进有意义的对话、患者参与和治疗同步对于建立强大的治疗联盟至关重要。这强调了在临床医生和患者之间建立深厚联系的重要性，这是有效以患者为中心的护理的核心。临床医生必须优先考虑双向沟通、同理心和患者协作，以确定个性化目标。强调触摸和寻求患者反馈也至关重要。需要进一步研究来探索这些要素及其影响。
