A grounded-theory investigation of patient education in physical therapy practice

Abstract

Patient education is a critical component of physical therapy and is used frequently in practice. Research describing the practice of patient education in physical therapy is scarce, however. Qualitative research methods can be used to describe the practice of patient education in physical therapy and to identify supportive theory. This study describes the practice of patient education grounded in data obtained from nine physical therapists in three settings: outpatient, acute care, and inpatient rehabilitation. From the data common themes are reported. From the themes, supportive theory can be identified. Results show four primary themes regarding patient education in physical therapy. First, the physical therapists in this study were not able to easily differentiate patient education from primary interventions. Second, the purpose of patient education was to empower patients toward self-management and prevention. Third, therapists used a patient-centered approach to decide upon content. Finally, each therapist used function or demonstration to assess the outcome of patient education interventions. The results of this study can be used to inform current practitioners, for future research and to identify theoretical underpinnings to support the practice of patient education in physical therapy.

Patient education best practice; enhancing physiotherapy students’ self-efficacy and skills

“…Previous research describing patient education within physiotherapy has identified central themes of promoting patient self-care and empowerment of the patient towards self-management (Rindflesch, 2009). Our results support these concepts where nearly all respondents in our study reported frequently teaching selfmanagement strategies and reported this activity to be important.…”

“…Early survey based research reports that 99% of physiotherapists perceive patient education as an important skill within their practice and 98% report participating in individual patient education as part of their patient care (May, 1983). More recent studies exploring patient education report that physiotherapists frequently engage in patient education centred on the principles of adult learning (Bresse and French, 2012) and self-efficacy (Rindflesch, 2009). Despite this, reports suggests physiotherapists do not routinely engage in education relating to health promotion and stress reduction (Sluijs et al, 1991;Fruth et al, 1998;Rindflesch, 2009), and find it challenging to provide explanations of cause of symptoms for common patient populations (Slade et al, 2012).…”

“…More recent studies exploring patient education report that physiotherapists frequently engage in patient education centred on the principles of adult learning (Bresse and French, 2012) and self-efficacy (Rindflesch, 2009). Despite this, reports suggests physiotherapists do not routinely engage in education relating to health promotion and stress reduction (Sluijs et al, 1991;Fruth et al, 1998;Rindflesch, 2009), and find it challenging to provide explanations of cause of symptoms for common patient populations (Slade et al, 2012). Further, patient education within physiotherapy has been described as being primarily clinician-centred or didactic in nature and often not individualised to the patient .…”

“…A variety of methods can be employed to deliver patient education including lectures, discussions, group activities and printed materials. Despite this, the available evidence indicates that patient education is ordinarily unplanned, spontaneous and embedded informally within wider care by health professionals (Gregor, 2001;Hult et al, 2009) including physiotherapists (Gahimer & Dumholdt, 1997;Rindflesch, 2009;Breese & French, 2012). This suggests that patient education in practice may be notably different to how it is outlined within definitions or theoretical interpretations of the term.…”

“…This small and variable research base, predominantly from the 1990's, indicates that patient education from physiotherapists focusses predominantly on content relating to the patient's physical illness and explanations regarding treatment and exercise. Only two studies to date have investigated approaches used by physiotherapists to evaluate patient education use Rindflesch, 2009) however these studies have not investigated use across levels of experience. The existing research has provided some insight into the perception of physiotherapists and students in relation to barriers to practice and the perception of the physiotherapist in relation to their patient education skill development .…”