Abstract
PurposeTo describe physiotherapists’ (PTs’) adoption of a theory-based skills training program preparing them to guide people with rheumatoid arthritis (RA) to health-enhancing physical activity (HEPA) within a 1-year intervention trial.MethodThis was a longitudinal case study. Ten female PTs (age 25–59), delivering the HEPA intervention, participated. Data were collected on five occasions over a 19-month period: once before the training course, once after 4 course days, twice during the HEPA intervention and once after the HEPA intervention. Knowledge on about physical activity (score 0–6) and behavior change techniques (BCTs) (score 0–18), fear-avoidance beliefs (score 8–48) and self-efficacy to guide behavior change (score 9–54) were assessed with a questionnaire. Structured logbooks were used to register PTs’ self-reported guiding behavior. Criteria for PTs’ adherence to the protocol were pre-set.ResultsPTs’ knowledge on about BCTs and their self-efficacy increased significantly (p < 0.05) from median 9 to 13 and from median 38 to 46.5, respectively. Knowledge on about physical activity was high and fear-avoidance beliefs were low before the education (median 6 and 13.5, respectively) and did not change over time. Two out of ten PTs fulfilled the pre-set criteria for adherence throughout the intervention.ConclusionThe results suggest that a theory-based skills training program improves PTs’ knowledge on about behavior change techniques and their self-efficacy to guide people with RA to HEPA. PTs’ adherence to the protocol was not complete but the clinical relevance of the adherence criteria need to be validated against observed PT behavior and patient outcomes.
Highlights
Physical therapists (PTs) are raised in a strong biomedical tradition focusing on physical aspects of functioning when assessing and treating patients [1]
The present study aimed to investigate, within a 1-year health-enhancing physical activity (HEPA) intervention trial, PTs’ adoption of a theory-based skills training program in guiding people with rheumatoid arthritis (RA) to increase their physical activity towards HEPA
Total scores for knowledge about physical activity and behavior change techniques (BCTs), fear-avoidance beliefs related to patients’ physical activity, and self-efficacy for guiding behavior change on the five measurement occasions are presented in Table 2 and Fig. 2
Summary
Physical therapists (PTs) are raised in a strong biomedical tradition focusing on physical aspects of functioning when assessing and treating patients [1]. (2018) 25:438–447 professionals with strong fear-avoidance beliefs are more likely to advise patients with back pain to limit their activities, despite clinical guidelines recommending advice to stay active [15]. Another belief predicting behavior is self-efficacy, defined as perceived own capability to perform a specific behavior in order to reach a goal [16]. It is a generic, strong determinant of individual behavior [17], including clinical practice among health professionals [18, 19]
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