Physiotherapeutic interactions: A review of the power dynamic

Williams, Shelley; Harrison, Karen

doi:10.1179/ptr.1999.4.1.37

Cited by 20 publications

(3 citation statements)

References 59 publications

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“…The unequal distribution of knowledge in medical settings and the patient-provider power dynamic are somewhat universal, our findings further contextualize these phenomena within the Malawian NCD clinical setting (Chapman, 1993;Williams and Harrison, 1999). We found providers heavily shape how patients feel about depression, suggesting the interaction must be handled with care.…”

Section: Addressing the Patient-provider Power Dynamicsupporting

confidence: 54%

Power and medical knowledge: a qualitative study of attitudes regarding co-occurring depression and chronic diseases in Malawi

Akiba

Zimba²,

Thom³

et al. 2019

Preprint

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Background : Globally, depression is a leading cause of morbidity and mortality particularly in Low and Middle-Income Countries (LMICs). The burden of non-communicable diseases (NCDs) are also increasing in LMICs, the conditions frequently co-occur and exacerbate NCD outcomes. Depression interventions alone are not effective at improving NCD outcomes resulting in wide-reaching calls for integrated services. Integrated services are in a nascent phase in LMICs in general and in Malawi in particular. This manuscript serves to clarify Malawian patients’ and providers’ attitudes towards depression integration into routine NCD services. Methods : Ten District Hospitals were selected for data collection. Thirty-nine participants were interviewed. An iterative approach to concept-driven coding was applied to facilitate the formation of similarities, differences, and connections between codes. Results : While patients infrequently described moderate depression as a medical condition, and held various attitudes regarding treatments, they agreed on the appropriateness of integrated services. Patients’ respect for their providers led them to support integration. Patients discussed how medical knowledge is highly regarded, revealing a power dynamic with their providers. Both patients and providers further acknowledged the power of a provider’s communication in shaping a patient’s feelings about depression. Conclusions : Training and interventions that facilitate providers abilities to effectively transfer their medical knowledge, use strategies to channel their power, and engage patients in a collaborative relationship will be key to successfully integrating depression treatment into Malawian NCD clinics and other integrative care settings in the region. Trial Registration : This work served as part of formative data collection for National Institute of Mental Health (NIMH) Trail NCT03711786 registered on 10 th October, 2018

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Section: Addressing the Patient-provider Power Dynamicsupporting

confidence: 54%

Power and medical knowledge: a qualitative study of attitudes regarding co-occurring depression and chronic diseases in Malawi

Akiba

Zimba²,

Thom³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…While the unequal distribution of knowledge in medical settings and the patient-provider power dynamic are somewhat universal, our findings further contextualize these phenomena within the Malawian NCD clinical setting [27,28]. Participants described how providers can heavily shape patients' feelings about depression, suggesting the interaction must be handled with care.…”

Section: Addressing the Patient-provider Power Dynamicmentioning

confidence: 53%

The role of patient-provider communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi

et al. 2020

View full text Add to dashboard Cite

Background: Globally, depression is a leading cause of morbidity and mortality particularly in Low and Middle-Income Countries (LMICs). The burden of non-communicable diseases (NCDs) are also increasing in LMICs, the conditions frequently co-occur and exacerbate NCD outcomes. Depression interventions alone are not effective at improving NCD outcomes, resulting in wide-reaching calls for integrated services. Integrated services are in a nascent phase in LMICs in general and in Malawi in particular. This manuscript serves to clarify Malawian patients' attitudes and perceptions towards depression integration into routine NCD services. Methods: Ten District Hospitals were selected for data collection and 2 participants were interviewed from each site (N = 20). An iterative approach to concept-driven coding was applied to facilitate the formation of similarities, differences, and connections between codes. Results: While patients infrequently described moderate depression as a medical condition, and held various attitudes regarding treatments, they agreed on the appropriateness of integrated services. Patients' respect for their providers led them to support integration. Patients discussed how medical knowledge is highly regarded, revealing a power dynamic with their providers. Patients further acknowledged the importance of a provider's communication in shaping a patient's feelings about depression. Conclusions: Training and interventions that facilitate providers' abilities to transfer their medical knowledge, use strategies to channel their power, and engage patients in a meaningful and collaborative relationship will be key to successfully integrating depression treatment into Malawian NCD clinics. Trial registration: This work served as part of formative data collection for National Institute of Mental Health (NIMH) Trail NCT03711786 registered on 10th October, 2018.

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“…Patients further expressed the importance of (1) the provider's role in effectively educating them about depression and 2communicating information about depression in a manner that would put them at ease, rather than exacerbate feelings of stress related to a depression diagnosis. These findings suggest the need for While the unequal distribution of knowledge in medical settings and the patient-provider power dynamic are somewhat universal, our findings further contextualize these phenomena within the Malawian NCD clinical setting (27,28). Participants described how providers can heavily shape patients' feelings about depression, suggesting the interaction must be handled with care.…”

Section: Discussion Overviewmentioning

confidence: 55%

The Role of Patient-provider Communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi

Akiba

Zimba²,

Thom³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Globally, depression is a leading cause of morbidity and mortality particularly in Low and Middle-Income Countries (LMICs). The burden of non-communicable diseases (NCDs) are also increasing in LMICs, the conditions frequently co-occur and exacerbate NCD outcomes. Depression interventions alone are not effective at improving NCD outcomes, resulting in wide-reaching calls for integrated services. Integrated services are in a nascent phase in LMICs in general and in Malawi in particular. This manuscript serves to clarify Malawian patients’ attitudes and perceptions towards depression integration into routine NCD services. Methods: Ten District Hospitals were selected for data collection and 2 participants were interviewed from each site (N=20). An iterative approach to concept-driven coding was applied to facilitate the formation of similarities, differences, and connections between codes. Results: While patients infrequently described moderate depression as a medical condition, and held various attitudes regarding treatments, they agreed on the appropriateness of integrated services. Patients’ respect for their providers led them to support integration. Patients discussed how medical knowledge is highly regarded, revealing a power dynamic with their providers. Patients further acknowledged the importance of a provider’s communication in shaping a patient’s feelings about depression. Conclusions: Training and interventions that facilitate providers’ abilities to transfer their medical knowledge, use strategies to channel their power, and engage patients in a meaningful and collaborative relationship will be key to successfully integrating depression treatment into Malawian NCD clinics. Trial Registration: This work served as part of formative data collection for National Institute of Mental Health (NIMH) Trail NCT03711786 registered on 10th October, 2018

show abstract

Physiotherapeutic interactions: A review of the power dynamic

Cited by 20 publications

References 59 publications

Power and medical knowledge: a qualitative study of attitudes regarding co-occurring depression and chronic diseases in Malawi

Power and medical knowledge: a qualitative study of attitudes regarding co-occurring depression and chronic diseases in Malawi

The role of patient-provider communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi

The Role of Patient-provider Communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi

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