Communication as negotiation processes in long‐term physiotherapy: a qualitative study

Øien, Aud Marie; Steihaug, Sissel; Iversen, Synnøve; Råheim, Målfrid

doi:10.1111/j.1471-6712.2010.00790.x

Cited by 30 publications

(21 citation statements)

References 28 publications

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“…With massage and exercises tuned into the patient’s rhythm of respiration, muscular tension and respiratory constrictions are reduced. Shifting towards a better dynamic between stability and freedom in motion, regulation of emotion and self‐reflection may be effected (1, 2). Ingrid also went to psychotherapy.…”

Section: Introductionmentioning

confidence: 99%

Touched in sensation – moved by respiration

Sviland

Råheim

Martinsen³

2012

Scandinavian Caring Sciences

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The aim of this theoretical article is to elaborate on the underpinning of Norwegian psychomotor physiotherapy (NPMP). With a narrative and hermeneutic point of departure, we explore the unfolding of a 10-year-long treatment by analysing a particular narrative from this treatment context in relation to some foundational perspectives on movement, sensation and time. A woman in her late thirties suffering from muscular tensions and pain, depression, anxiety and anorexia, came for NPMP. The investigation of her treatment experience is based on the journal written by her physiotherapist and first author of this article. We suggest that new experiences in movement and sensation as well as changes in movement patterns can contribute to retuning in sensation and restructuring of narrative time. Feeding the fictional space and narrative fantasy with new experiences in movement and sensation can help counteracting delusional ideas and assist changes, supporting embodied narrative identity. Ingrid's experience is discussed in the light of Trygve Braatøy's understanding of muscular functions, Knud E Løgstrup's phenomenology of sensation and Paul Ricouer's narrative time.

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Section: Introductionmentioning

confidence: 99%

Touched in sensation – moved by respiration

Sviland

Råheim

Martinsen³

2012

Scandinavian Caring Sciences

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“…Rosbergs (61) informanter beskrev strategin att reglera antalet patienter med krävande problematik. Eftersom kliniska samtal inte sällan är utmanande är det mer ändamålsenligt att som Öien et al (156) tala om svåra situationer, där terapeuten ser sig själv som en del av problemet (48,150) än om svåra patienter. Några fysioterapeuter (arbete IV) beskrev att vissa samtal inte gav så mycket.…”

Section: Nyckelfrågorna I Det Kliniska Samtalet öPpnar För Att Möta Dunclassified

Att leva med en kropp som värker : samtal med fysioterapeuten

Afrell¹

2014

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Background and aim: Physiotherapists in primary care meet, assess and treat patients with long-standing benign musculoskeletal pain. As a clinical condition, long-standing pain is common but nonetheless it is quite complex. The aim of this thesis has been, from a bodily existential perspective, to investigate and conceptualise the experience of living with longstanding benign musculoskeletal pain, and from there, to work out a method for conversation and assessment within non-specialised physiotherapy. Methods: Our first study was an interview study where we applied a phenomenological approach and investigated the ways individuals suffering from long-standing pain experienced their body and their illness. Four aspects of body experience were described, and based on these aspects, four typologies of attitudes to pain were distinguished. In the second study, we made two group interviews with six physiotherapists about their experiences of using, in their clinical work, questions from the interview guide in study I that had given particularly rich responses. Transcripts were analysed using phenomenography. In the third study, patients’ verbal responses to the key questions, directed to them by physiotherapists in clinical situations, were investigated, and the four aspects of body experience from study I formed the concepts of a deductive analysis. In study IV, finally, the key questions and typologies were tried by a larger group (31), and their experiences and the possible applicability of the method were studied by qualitative content analysis combined with the counting of codes. Results: We created four typologies of attitudes to long-standing pain: “Surrendering to one’s fate”, “Accepting by an active process of change”, “Balancing between hope and resignation” and “Rejecting the body”. These typologies, in turn, were based on four aspects of body experience: “The body as an aspect of identity”. “Body reliance”, “Body awareness”, and “Ways of understanding pain”. In study II, by the aid of key questions, patient and physiotherapist managed to have a conversation on bodily existential matters. The physiotherapist learnt to know the patient as a person, a process appeared to be initiated in the patient, and their relation changed. The patient was willing to talk about her body in pain, and had the words to do this. In study III, the key questions opened ways to reflections on body, existence, and biography. The four aspects of body experience were central to the patients’ descriptions. In study IV, the participating physiotherapists reported by large positive experiences from applying key questions and typologies. The patients reflected, emotions were evoked, and the relation and the communication often improved. The typologies helped in giving a comprehensive perspective of the patient’s problem, and to grasp where in the process of rehabilitation the patient was to be found. Conclusions: The method, seven key questions combined with the tentative frame of interpretation of the answers, seemed to be easily appl...

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“…treatments for patients with chronic pain), participants influence each other reciprocally and create new ways of interaction (i.e. ‘negotiate the relationship’), showing thereby the dynamic nature of communication (Øien et al ., , p. 57). Even though communication skills are seen to be crucial for establishing an effective patient–physiotherapist relationship (Butow and Sharpe, ), evidence seems to suggest that physiotherapists struggle to identify and address the patients' psychosocial needs (Sanders et al ., ).…”

Section: Introductionmentioning

confidence: 95%