Implementation of person‐centred practice principles and behaviour change techniques after a 2‐day training workshop: A nested case study involving physiotherapists

Abstract

Objectives The aims of the present study were to determine how well physiotherapists implemented person‐centred practice principles and behaviour change techniques after a workshop, and to evaluate whether self‐audit of performance differed from audits of an experienced training facilitator. Methods Eight physiotherapists each completed a 2‐day workshop followed by two telephone consultations with four patients with knee osteoarthritis. The training facilitator audited audio‐recordings of all consultations, and therapists self‐audited 50% of consultations using a tool comprising: (a) 10 person‐centred practice principles rated on a numerical rating scale of 0 (need to work on this) to 10 (doing really well); and (b) seven behaviour change techniques rated with an ordinal scale (using this technique effectively; need to improve skill level; or need to learn how to apply this technique). Results Physiotherapists showed “moderate” fidelity to person‐centred principles, with mean scores between 5 and 7 out of 10. For behaviour change techniques, the training facilitator believed that physiotherapists were using three of seven techniques “effectively” during most consultations and “needed to improve skill levels” with most other techniques. Physiotherapists scored themselves significantly lower than the training facilitator for two of 10 person‐centred principles, and tended to rate their skills using behaviour change techniques less favourably. Conclusions Physiotherapists performed moderately well when implementing person‐centred practice principles and behaviour change techniques immediately after training, but had room for improvement, particularly for skills relating to providing management options and changing thinking habits. Physiotherapists' self‐ratings of performance generally did not differ from expert ratings; however, they underestimated their ability to implement some principles and techniques.

Does telephone-delivered exercise advice and support by physiotherapists improve pain and/or function in people with knee osteoarthritis? Telecare randomised controlled trial

“…Consultations focused on best-evidence physiotherapy that was personally tailored and supported by behavioural change principles. Although this resulted in a complex intervention requiring specialised physiotherapist training,25 26 this was worthwhile given the high satisfaction and excellent adherence observed. The trial was robust, with participant and assessor blinding, high retention and accompanied by cost-effectiveness analyses.…”

“…Briefly, eight physiotherapists were trained (HealthChange Methodology (HealthChange Australia)) to deliver person-centred exercise-based care using theoretically informed behavioural change techniques. Details about training21 and its outcomes25 26 are published.…”

Osteoarthritis management care pathways are complex and inefficient: A qualitative study of physiotherapist perspectives from specialised osteoarthritis services

“…Cognitive behavioural therapies for depression have been recommended in recent osteoarthritis guidelines (Bannuru et al., 2019 ; Kolasinski et al., 2020 ). While physiotherapists can be trained in cognitive behavioural therapy (Lawford et al., 2019 ), our findings indicate the need for improved funding within or external to osteoarthritis services to provide appropriate psychological management.…”

The value of allied health professional research engagement on healthcare performance: a systematic review

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