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Vol. 22. Num. 6.01 November 2018
Pages 435-526
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Vol. 22. Num. 6.01 November 2018
Pages 435-526
Original Research
DOI: 10.1016/j.bjpt.2018.04.003
Physical therapists’ perceptions and experiences about barriers and facilitators of therapeutic patient-centred relationships during outpatient rehabilitation: a qualitative study
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Jaume Morera-Balaguera, José Martín Botella-Ricoa, Mari Carmen Martínez-Gonzáleza, Francesc Medina-Mirapeixb, Óscar Rodríguez-Nogueirac,
Corresponding author
orodn@unileon.es

Corresponding author at: University of León, Health Sciences School, Nursing and Physical Therapy Department, Av. Astorga s/n Campus Ponferrada, 24402 Ponferrada León, Spain.
a Department of Physical Therapy, Universidad CEU Cardenal Herrera, Plaza Reyes Católicos, Spain
b Department of Physical Therapy, Regional Campus of International Excellence “Campus Mare Nostrum,” University of Murcia, Murcia, Spain
c Nursing and Physical Therapy Department, Health Sciences School, Universidad de León, Ponferrada León, Spain
Highlights

  • Physical therapist's perception regarding therapeutic patient-centred relationship.

  • Improve understanding patients’ contextual factors and features of physical space.

  • Patient-centred relationship depends on professional, patient's attitudes and context.

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Tables (4)
Table 1. Thematic guide for focus group discussions.
Table 2. Characteristics of the physical therapist participants.
Table 3. Map of themes, subthemes and categories according to the perceptions and experiences expressed in the physical therapy focus groups.
Table 4. Categories and subcategories of barriers and facilitators and their definitions.
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Abstract
Background

Over recent years there has been a paradigm shift towards a patient-centred biopsychosocial care model in physical therapy. This new paradigm features a growing interest in understanding the contextual factors that influence the patient's experience of disease, pain and recovery. This includes generalized consensus regarding the importance of establishing a therapeutic relationship that is centred on the patient.

Objective

To explore physical therapists’ perceptions and experiences regarding barriers and facilitators of therapeutic patient-centred relationships in outpatient rehabilitation settings.

Methods

This is a qualitative study with four focus groups including twenty-one physical therapists. Two researchers conducted the focus groups, using a topic guide with predetermined questions. The focus group discussions were audiotaped and videotaped, transcribed verbatim and analysed thematically using a modified grounded theory approach.

Results

Physical therapists perceived that the therapeutic patient-centred relationship not only depends on the personal qualities of the professional, but also on the patient's attitudes and the characteristics of the context, including the organization and team coordination.

Conclusions

Although being more linked towards the patients’ contextual factors and needs than towards the practice of the profession, a therapeutic relationship is worth considering by physical therapists. Furthermore this study highlights the need for physical therapists and administrators to rethink the situation and propose strategies for improvement.

Keywords:
Patient centred care
Physical therapy
Professional patient relations
Communication
Focus groups
Rehabilitation

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