Some UK Experience of Gauging Progress on Introducing Sustainable Business Practices in the Construction Sector

Abstract

Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.Methods: Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level.Results: Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities. Conclusion:This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.

Sustainable development

“…Across all groups, initially answers were quite vague and were articulated in terms of energy and environmental impact, however, as the discussion progressed it became clear that participants did have more of an understanding of SD and the other dimensions it encompasses. In particular, whilst the literature posits that the social dimension is thought to be largely ignored (Drexhage and Murphy, 2010;Cooper et al, 2005) it was clear from responses across all groups that this aspect of SD is recognised by industry through their working practices and that it is becoming increasingly important on the agenda with references made across all groups to involving the local community, obtaining apprentices and creating jobs locally and that construction does not affect the people in the local area but rather benefits them. The economic dimension of SD was not mentioned directly but it was implicit through answers pertaining to how the CI can influence social outcomes and how this can generate growth within communities through the provision of apprenticeships and jobs for local people.…”

“…Despite this surge of interest, the prevalence of SD in the CI is still lagging behind that of other industries (Cabinet Office, 2011). A number of reports in the literature have investigated this and have identified a number of barriers which preclude implementation namely cost (Sponge, 2004;Cotgrave, 2008;Pitt et al, 2009) lack of knowledge (Chong et al, 2009;Constructing Excellence, 2008;Baker and Associates, 2006;Sponge, 2004), patterns of ambiguity in legislation (Cooper et al, 2005;Rodriguez-Melo and Mansouri, 2011) and unclear roles of responsibility (Osmani et al, 2006(Osmani et al, , 2008Saunders and Wynn, 2004).…”

“…Whilst SD is intended to encompass all three aspects, more often than not the environmental dimension is given more credence (Drexhage and Murphy, 2010;Cooper et al, 2005), which is perhaps unsurprising given that climate change is given high priority in many government agendas. However, true SD cannot be achieved unless a holistic approach is taken incorporating all three tenets (Giddings et al, 2002;Hopwood et al, 2005).…”