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|Title: ||A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: face validity and feasibility of implementation|
|Authors: ||Matthews, James|
Hall, Amanda M.
Taylor, Ian M.
Lonsdale, Chris C.
Hurley, Deirdre A.
Theoretical domain framework
Low back pain
|Issue Date: ||2015|
|Publisher: ||BioMed Central / © The Authors|
|Citation: ||MATTHEWS, J. ... et al, 2015. A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: face validity and feasibility of implementation. BMC Health Services Research, 15, 260.|
Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient’s motivation and maintenance of self-management behaviours can be positively influenced by the clinician’s use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice.
A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. Results
Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for refinement prior to scaling up for a definitive trial.
The development process utilised in this study ensured the intervention was theory-informed and evidence-based, with recipients signalling its relevance and benefit to their clinical practice. Future research should consider additional intervention strategies to address barriers of social support and those beyond the clinician level.|
|Description: ||This is an Open Access article published by BioMed Central and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0),|
|Sponsor: ||We acknowledge the Health Research Board for a Health Research Award
(HRA_POR/2010/102/k) that funded this project|
|Publisher Link: ||http://dx.doi.org/10.1186/s12913-015-0921-1|
|Appears in Collections:||Published Articles (Sport, Exercise and Health Sciences)|
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