Patients as Partners in Research: A Practical Example of How Researchers Are Contributing to the Patient-Partnership Revolution

Mescouto, Karime; Setchell, Jenny

doi:10.2519/jospt.2020.0105

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…These ‘patients’ were advisors , not participants; we incorporated/embedded their ideas in our results along with those of researchers and clinicians and used exercises from the design industry to collate the ideas. (Mescouto & Setchell, 2020).…”

Section: Methodology and Methodsmentioning

confidence: 99%

Physiotherapists Both Reproduce and Resist Biomedical Dominance when Working With People With Low Back Pain: A Qualitative Study Towards New Praxis

et al. 2022

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Despite recommendations to incorporate physical and psychosocial factors when providing care for people with back pain, research suggests that physiotherapists continue to focus on biological aspects. This study investigated how interpersonal and institutional norms influence this continued enactment of the biological aspects of management. We used theoretically-driven analysis, drawing from Foucauldian notions of power, to analyse 28 ethnographic observations of consultations and seven group discussions with physiotherapists. Analysis suggested that physiotherapy training established expectations of what a physiotherapist ‘should’ focus on, and institutional circumstances strongly drew the attention of physiotherapists towards biological aspects. Resistance to these forces was possible when, for example, physiotherapists reflected upon their practice, used silences and pauses during consultations, and actively collaborated with patients. These circumstances facilitated use of non-biomedical management approaches. Findings may assist physiotherapists to rework the enduring normative focus on biomedical aspects of care when providing care for patients with back pain.

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Section: Methodology and Methodsmentioning

confidence: 99%

Physiotherapists Both Reproduce and Resist Biomedical Dominance when Working With People With Low Back Pain: A Qualitative Study Towards New Praxis

et al. 2022

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“…Data analysis was initially performed inductively in three distinct collaborative spaces: clinician dialogues (see above), consumer advisory panels and research team analysis meetings. The consumer panels (3 × 2-hour panels) consisted of three people with lived experience of LBP providing expertise, analysis and feedback on the study (Mescouto and Setchell, 2020). Research team analysis involved eleven 2-hour meetings over a 1-year period.…”

Section: Discussionmentioning

confidence: 99%

‘Engaging on a slightly more human level’: A qualitative study exploring the care of individuals with back pain in a multidisciplinary pain clinic

et al. 2022

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Chronic low back pain is characterised by multiple and overlapping biological, psychological, social and broader dimensions, affecting individuals’ lives. Multidisciplinary pain services have been considered optimal settings to account for the multidimensionality of chronic low back pain but have largely focused on cognitive and behavioural aspects of individuals’ pain. Social dimensions are usually underexplored, considered outside or beyond healthcare professionals’ scope of practice. Employing Actor Network Theorist Mol’s concept multiplicity, our aim in this paper is to explore how a pain service’s practices bring to the fore the social dimensions of individuals living with low back pain. Drawing on 32 ethnographic observations and four group exchanges with the service’s clinicians, findings suggest that practices produced multiple enactments of an individual with low back pain. Although individuals’ social context was present and manifested during consultations at the pain service (first enactment: ‘the person’), it was often disconnected from care and overlooked in ‘treatment/management’ (second enactment: ‘the patient’). In contrast, certain practices at the pain service not only provided acknowledgement of, but actions towards enhancing, individuals’ social contexts by adapting rules and habits, providing assistance outside the service and shifting power relations during consultations (third enactment: ‘the patient-person’). We therefore argue that different practices enact different versions of an individual with low back pain in pain services, and that engagement with individuals’ social contexts can be part of a service’s agenda.

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“…During panels, researchers guided discussions about emerging findings from observations and gathered advice regarding areas for improvement, with their prior experiences in consideration. 39 Panel discussions informed our analysis.…”

Section: Methodsmentioning

confidence: 98%

Reciprocity in Low Back Pain Care and Its Role in Power Dynamics: A Give-and-Take Approach

2022

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Objective The shift toward patient-centered care in physical therapy fostered a deeper consideration of power-sharing in clinical interactions. Elements of reciprocity may enhance such power considerations between physical therapist and patients, but there has been little investigation into how reciprocity is enacted in physical therapy, its value, and how to improve it if required. This study investigates forms of reciprocity during physical therapist–patient interactions in low back pain (LBP) care with the aim of enhancing patient-centered approaches. Methods The qualitative design involved: (1) ethnographic observations at a fee-for-service practice in Australia, and (2) reflexive discussions between researchers and participating clinicians. To understand reciprocity, the analysis drew from the concepts of “accepting’”(or “blocking”) “offers” that have been previously applied to physical therapy interactions. The analysis is a sub-study using a larger dataset and analyses in which we partnered with physical therapists and people living with LBP. Results Forty-nine observations and 13 reflexive discussions were undertaken with 42 people with LBP and 10 physical therapists. Analysis developed 3 themes suggesting that forms of reciprocity depended on physical therapists accepting or blocking patients’ offers, inviting patients to make an offer, and offering personal stories. These elements of reciprocity are relevant to power sharing during interactions and may impact patient-centered care. Conclusion Our results suggest that attending to forms of reciprocity can help physical therapists shift power in clinical interactions. By inviting and accepting “offers,” physical therapists may build collaborative interactions, support patients to guide the treatment narrative, and shift away from biomedically centered management approaches. Such recommendations create reciprocal environments that might enhance patient-centered care.

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Patients as Partners in Research: A Practical Example of How Researchers Are Contributing to the Patient-Partnership Revolution

Cited by 6 publications

References 8 publications

Physiotherapists Both Reproduce and Resist Biomedical Dominance when Working With People With Low Back Pain: A Qualitative Study Towards New Praxis

Physiotherapists Both Reproduce and Resist Biomedical Dominance when Working With People With Low Back Pain: A Qualitative Study Towards New Praxis

‘Engaging on a slightly more human level’: A qualitative study exploring the care of individuals with back pain in a multidisciplinary pain clinic

Reciprocity in Low Back Pain Care and Its Role in Power Dynamics: A Give-and-Take Approach

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