Amy Hiller1, Marilys Guillemin2, Clare Delany3. 1. Centre for Health Equity, The University of Melbourne, Melbourne, Australia; Department of Physiotherapy, The University of Melbourne, Melbourne, Australia. Electronic address: a.terry@student.unimelb.edu.au. 2. Centre for Health Equity, The University of Melbourne, Melbourne, Australia. 3. Department of Physiotherapy, The University of Melbourne, Melbourne, Australia.
Abstract
OBJECTIVE: This project explored whether models of healthcare communication are evident within patient-physiotherapist communication in the private practice setting. METHODS: Using qualitative ethnographic methods, fifty-two patient-physiotherapist treatment sessions were observed and interviews with nine physiotherapists were undertaken. Data were analyzed using thematic analysis. RESULTS: In these clinical encounters physiotherapists led the communication. The communication was structured and focussed on physical aspects of the patient's presentation. These features were mediated via casual conversation and the use of touch to respond to the individual patient. Physiotherapists did not explicitly link their therapeutic communication style to established communication models. However, they described a purposeful approach to how they communicated within the treatment encounter. CONCLUSION: The communication occurring in the private practice physiotherapy treatment encounter is predominantly representative of a 'practitioner-centred' model. However, the subtle use of touch and casual conversation implicitly communicate competence and care, representative of a patient-centred model. Physiotherapists do not explicitly draw from theories of communication to inform their practice. PRACTICE IMPLICATIONS: Physiotherapists may benefit from further education to achieve patient-centred communication. Equally, the incorporation of casual conversation and the use of touch into theory of physiotherapy patient-centred communication would highlight these specific skills that physiotherapists already utilize in practice.
OBJECTIVE: This project explored whether models of healthcare communication are evident within patient-physiotherapist communication in the private practice setting. METHODS: Using qualitative ethnographic methods, fifty-two patient-physiotherapist treatment sessions were observed and interviews with nine physiotherapists were undertaken. Data were analyzed using thematic analysis. RESULTS: In these clinical encounters physiotherapists led the communication. The communication was structured and focussed on physical aspects of the patient's presentation. These features were mediated via casual conversation and the use of touch to respond to the individual patient. Physiotherapists did not explicitly link their therapeutic communication style to established communication models. However, they described a purposeful approach to how they communicated within the treatment encounter. CONCLUSION: The communication occurring in the private practice physiotherapy treatment encounter is predominantly representative of a 'practitioner-centred' model. However, the subtle use of touch and casual conversation implicitly communicate competence and care, representative of a patient-centred model. Physiotherapists do not explicitly draw from theories of communication to inform their practice. PRACTICE IMPLICATIONS: Physiotherapists may benefit from further education to achieve patient-centred communication. Equally, the incorporation of casual conversation and the use of touch into theory of physiotherapy patient-centred communication would highlight these specific skills that physiotherapists already utilize in practice.
Authors: C Emilson; P Åsenlöf; S Pettersson; S Bergman; M Sandborgh; C Martin; I Demmelmaier Journal: BMC Musculoskelet Disord Date: 2016-07-27 Impact factor: 2.362