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

Matthews, James; Hall, Amanda; Hernon, Marian; Murray, Aisling; Jackson, Ben; Taylor, Ian; Toner, John; Guérin, Suzanne; Lonsdale, Chris; Hurley, Deirdre A.

doi:10.1186/s12913-015-0921-1

Cited by 28 publications

(31 citation statements)

References 43 publications

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“…Specifically, within the SOLAS intervention, this criteria should highlight how these BCTs should be fully delivered using a SDT-based communication style, as a recent review found that a person-centred manner of BCT delivery explained all of the between-study variations in long-term behaviour maintenance, thus supporting its inclusion for effective interventions (Samdal et al, 2017). Furthermore, as fidelity guidelines suggest that providers be monitored during delivery (Bellg et al, 2004;Borelli, 2011), individualized feedback could be provided to those that need it (Fixsen, Blase, Metz, & VanDyke, 2013;Matthews et al, 2015). Therefore, individual 'booster' or 'coaching' sessions could be considered within future training programmes to further enhance provider delivery.…”

Section: The Effectiveness Of Bct Training Within the Solas Interventionmentioning

confidence: 99%

An assessment of physiotherapist’s delivery of behaviour change techniques within the SOLAS feasibility trial

Keogh

Matthews

Hurley

2018

British J Health Psychol

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Delivering the SOLAS intervention BCTs with high fidelity was not feasible. The assessment of partial delivery of BCTs provided greater insight into the techniques that should be removed from the protocol or that may require further training. Complex interventions should consider a list of 'core' or mandatory BCTs alongside 'optional' BCTs, depending on the target behaviour, and the needs of individual participants. Statement of contribution What is already known on this subject? BCTs are the smallest active components of behavioural interventions, yet typically their effectiveness is determined through meta-analyses. Attempted delivery of BCTs is often unaccounted for yet may provide valuable insight into difficulty with delivery. There is a need to investigate BCT implementation beyond simple presence/absence to identify protocol refinements or required BCT training. What does this study add? BCT delivery was assessed in greater depth than previous research, including partial delivery. Highlights the need for appropriate training in BCTs that are difficult to deliver, particularly those associated with 'goals and planning' Highlights the need for intervention-specific criteria as to what constitutes 'high', 'moderate', and 'low' fidelity.

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Section: The Effectiveness Of Bct Training Within the Solas Interventionmentioning

confidence: 99%

An assessment of physiotherapist’s delivery of behaviour change techniques within the SOLAS feasibility trial

Keogh

Matthews

Hurley

2018

British J Health Psychol

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“…In addition to the video-taped sessions used in the pilot study, the clinicians also had the opportunity to work on phrasing and delivery through active case scenarios. Use of mixed training methods (didactic and interactive) have shown to be more effective than a single method alone (Forsetlund et al, 2009; Matthews et al, 2015). Throughout the training sessions, the clinicians were encouraged to begin trying the techniques.…”

Section: Methodsmentioning

confidence: 99%

Enhanced Medical Rehabilitation: Effectiveness of a clinical training model

Bland

Birkenmeier

Barco

et al. 2016

NRE

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Background Patient engagement in medical rehabilitation can be greatly influenced by their provider during therapy sessions. We developed Enhanced Medical Rehabilitation (EMR), a set of provider skills grounded in theories of behavior change. EMR utilizes 18 motivational techniques focused on providing frequent feedback to patients on their effort and progress and linking these to patient goals. Objective To examine the effectiveness of a clinical training protocol for clinicians to do EMR, as measured by clinician adherence. Methods A physical therapist, physical therapist assistant, occupational therapist, and certified occupational therapist assistant were trained in EMR. Training consisted of five formal training sessions and individual and group coaching. Adherence to EMR techniques was measured during two phases: Pre-Training and Maintenance, with an a priori target of 90% adherence by clinicians to each EMR technique. Results With training and coaching, clinician adherence per therapeutic activity significantly improved in 13 out of 18 items (p < .05). The target of 90% adherence was not achieved for many items. Conclusions Our training and coaching program successfully trained clinicians to promote patient engagement during therapeutic service delivery, although not typically to 90% or greater adherence. Ongoing coaching efforts were necessary to increase adherence.

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“…SDT-based interventions typically include a series of communication strategies targeting a patient's basic needs (e.g. asking open-ended questions, paraphrasing and gauging the patient's readiness to accept advice); we have previously demonstrated that this type of training can increase physiotherapists' autonomy supportive behaviour in their clinical interactions with patients [5].…”

Section: Self-determination Theory and Patient Adherence To Treatmentmentioning

confidence: 96%

Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool

Murray

Hall

Williams

et al. 2018

Disability and Rehabilitation

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Results provide preliminary evidence to support future use and testing of the Communication Evaluation in Rehabilitation Tool. Implications for Rehabilitation Promoting patient autonomy is a learned skill and while interventions exist to train clinicians in these skills there are no tools to assess how well clinicians use these skills when interacting with a patient. The lack of robust assessment has severe implications regarding both the fidelity of clinician training packages and resulting outcomes for promoting patient autonomy. This study has developed a novel measurement tool Communication Evaluation in Rehabilitation Tool and a comprehensive user manual to assess how well health care providers use autonomy-supportive communication strategies in real world-clinical settings. This tool has demonstrated good inter-rater reliability and concurrent validity in its initial testing phase. The Communication Evaluation in Rehabilitation Tool can be used in future studies to assess autonomy-supportive communication and undergo further measurement property testing as per our recommendations.

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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

Cited by 28 publications

References 43 publications

An assessment of physiotherapist’s delivery of behaviour change techniques within the SOLAS feasibility trial

An assessment of physiotherapist’s delivery of behaviour change techniques within the SOLAS feasibility trial

Enhanced Medical Rehabilitation: Effectiveness of a clinical training model

Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool

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