‘We got the whole story all at once’: physiotherapists’ use of key questions when meeting patients with long‐standing pain

Abstract

Long-standing musculoskeletal pain has many dimensions. Physiotherapy lacks a tested method of dialogue with which physiotherapists and patients can together explore pain in all its complexity. The present aim was to find out how physiotherapists experienced the influence of systematically prepared key questioning on their relation to, and understanding of, patients with long-standing pain. A group of six physiotherapists with long experience of pain rehabilitation used such questions in their encounters with their patients. Two periods of work with the questions were followed by discussions in which the physiotherapists shared their experience in a joint focus group. Verbatim transcripts of the discussions constitute the data of the study. A phenomenographic method was used for the analysis. The responses to the key questions gave the physiotherapists an insight into the patient as a person. The questions started a process of change in the patient, and changed the physiotherapist's relation to her or him. The patient expressed feelings and experience, and this also seemed to encourage a change in chosen coping strategies. This new content of the interaction challenged the physiotherapist's role, thus raising questions about her professional mandate.

Meta-ethnography to understand healthcare professionals’ experience of treating adults with chronic non-malignant pain

“…The themes are drawn from a wide range of HCPs, including those specialising in chronic pain management who may be more likely to adopt a biopsychosocial approach. 146 147 155 157 164 185 198 199 211 212 215 217 219 …”

“…If you start from the body and if you ask a little carefully how things work when you are physically like that, then it is not threatening, and you can approach things, like, through the body. 146 (Afrell, 2010, pain specialist, physiotherapist, Norway)…”

Meanings of “acceptance” for patients with long-term pain when starting rehabilitation

“…She found that the dialogue started a process of change and it is possible to discuss these types of issues with patients, but physiotherapists need support in order to take up such topics. This was a matter of uncertainly about the professional role or mandate of physioterapist (Afrell & Rudebeck, 2010).…”

Experiences by patients and health professionals of a multidisciplinary intervention for long-term orofacial pain

“…Many health care researchers with a professional background in somatic care are astonished initially at the interventional power their interviews seem to have when they are performing a qualitative study addressing a patient group. One of them is the Swedish physiotherapist Maria Afrell who, whilst exploring patients’ experiences of “living with a body in pain”, found that her method of asking questions had interventional power 21,22. In our study, the patients’ descriptions indicate that the narrative approach taken by the consultant team might have been key to the success of the intervention.…”