Physiotherapists’ Approaches to Patients’ Concerns in Back Pain Consultations Following a Psychologically Informed Training Program
Open accessAbstract
Guidelines advocate a combined physical and psychological approach to managing non-specific chronic low back pain (NSCLBP), referred to as psychologically informed practice (PIP). PIP is underpinned by patient-centered principles and skilled communication. Evidence suggests that a physiotherapist-focused style of communication prevails in physiotherapy. There is a recognized need for observational research to identify specific communication practices in physiotherapy interactions. This observational study explored the interactional negotiation of agenda setting following a PIP training intervention, by identifying and describing how physiotherapists solicit and respond to the agenda of concerns that patients with NSCLBP bring to primary care initial encounters. The research setting was primary care. Nineteen initial physiotherapy consultations were video-recorded, transcribed, and analyzed using conversation analysis, a qualitative observational method. These data revealed a patient-focused style of communication where trained physiotherapists demonstrated a collaborative and responsive style of verbal and nonverbal communication to solicit, explore, and validate patients’ concerns.
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Psychologically informed physical therapy programs help physical therapists integrate emotional and cognitive components of care and are advantageous to implementation of interdisciplinary programs.
“The development of psychologically informed physical therapy (PiPT) programs help physical therapists integrate emotional/cognitive components of care and is advantageous to implementation of interdisciplinary programs.22,29-31”
From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [29]
The Discussion (Exploring Patients’ Emotional Concerns; page unavailable) reports that physiotherapists following training treated patients’ emotional concerns as integral to consultations. The Conclusion (page unavailable) describes greater exploration and validation of patients’ concerns after training. But the paper does not establish that the program caused these changes or show that it benefited implementation of interdisciplinary programs; the Methods explicitly say its non-randomized design cannot determine training effectiveness. (LLM, conf=0.87)
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- Authors
- Cowell, I., McGregor, A., O’Sullivan, P., O’Sullivan, K., Poyton, R., Schoeb, V., & Murtagh, G.
- Affiliations
- Imperial College London (GB)
- Curtin University (AU)
- University of Limerick (IE)
- HES-SO University of Applied Sciences and Arts Western Switzerland (CH)
- Corresponding author
- Cowell, Ian
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2021-10-07
- Volume
- 31
- Issue
- 13
- Pages
- 2486-2501
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- PMC
- PMC8579327
- OpenAlex
- W3204281985
- Cited by
- 22
- References
- 85
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 3
- FWCI
- 4.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Qualitative Health Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
- University of Limerick Institutional Repository (University of Limerick) (submittedVersion, cc-by-nc-sa)
- Figshare (submittedVersion, cc-by-nc-sa)
- ArODES (HES-SO (https://www.hes-so.ch/)) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Private Physiotherapy Educational Foundation
- Musculoskeletal Association of Chartered Physiotherapists
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- chronic non-specific low back pain, physiotherapist-patient communication, agenda setting, patient concerns, patient-centered care, primary care physiotherapy, nonverbal communication, collaborative communication, training program
- MeSH terms
- Attitude of Health Personnel, Humans, Professional-Patient Relations, Referral and Consultation, Research Design, Low Back Pain, Physical Therapy Modalities, Physical Therapists
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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