What matters most to people in musculoskeletal physiotherapy consultations? A qualitative study

The advanced practitioners’ perspective. Exploring the decision‐making process between musculoskeletal advanced practitioners and their patients: An interpretive phenomenological study

“…This research provides new evidence and contributes understanding to the complex and fluid decision‐making process that occurs between APs and patients. Prior research into how physiotherapists make decisions shows a predominance for paternalistic decision‐making (Dierckx et al., 2013; Jones et al., 2014; Stenner et al., 2018), whereas this research showed MSK APs using a broader range of decision‐making styles. APs in this study illustrated the dilemmas that can exist in relation to how decision‐making is approached and sometimes switched their own style within or between consultations.…”

People’s Experience of Shared Decision Making in Musculoskeletal Physiotherapy: A Systematic Review and Thematic Synthesis

“…In this review, a lack of knowledge and confidence left people unable to challenge the physiotherapist and unable to help themselves, resulting in dependency and disempowerment. An inability to participate due to lack of information, confidence or an absence of an environment that encourages collaboration, should not be confused with not wanting to participate [ 18 , 59 ]. This could be as simple as giving explicit permission for people to be involved [ 46 ] or as complex as challenging attitudes and behaviours at the individual and societal level [ 60 ].…”

“…Research that has been published in this area often focusses on clinician viewpoints or observer perceptions as opposed to the perspective of patients [ 13 , 14 , 15 ], despite the suggestion that understanding public views is essential if SDM is to be fully embedded in healthcare [ 16 ]. Initial research that has focussed on MSK physiotherapy patients has shown that SDM may enhance trust, satisfaction and empowerment to participate in decision-making [ 17 , 18 ], but these findings are vague and varied [ 18 , 19 , 20 ]. Other studies use quantitative methods to investigate this phenomena [ 21 ], which may misrepresent findings and therefore our understanding of this complex phenomena [ 21 , 22 ].…”

Implementation of a provider based musculoskeletal first contact physiotherapy service model: Key points to consider

“…MSK conditions can be over investigated and the efficacy of an increasing number of surgical procedures and injections is being questioned (Orchard, 2020). Therefore while these are important skills they are not essential and the emphasis for the FCP role should be on first line management focusing on normalising age‐related findings, lifestyle factors and identifying what matters most to the patients (Lewis, Cook, Hoffman, & O'Sullivan, 2020; Stenner, Hammond, & Palmer, 2018). In Somerset, we have placed increasing importance on staff developing the ‘softer’ skills such as agenda setting, shared decision making and self‐management support through health coaching.…”