What matters most to people in musculoskeletal physiotherapy consultations? A qualitative study

Abstract

BackgroundPerson-centred approaches to care require clinicians to engage in trying to understand the full range of problems and concerns, treatment and investigation requests, and emotional and social issues that people bring to the consultation. If, however, the main issues of importance are not openly declared and discussed they cannot be addressed. This is likely to result in people receiving the care that clinicians think they need, rather than care based on individual needs and preferences. ObjectiveTo understand people's abilities to express the issues of importance to them within a consultation and clinicians' abilities to acknowledge and address those issues. DesignA qualitative study using an interpretive phenomenological approach. MethodsFifteen people and their physiotherapists were interviewed and their consultations recorded. The resulting data sets were analysed to identify and report themes within the data. FindingsThe findings revealed that people present with what are often simple issues, but which are sometimes expressed in an unstructured way in clinical encounters and are often difficult for clinicians to establish. Three linked themes emerged: (1) clear versus unstructured agendas; (2) people need information and understanding; and (3) developing a sense of collaboration. ConclusionsThe issues of importance that people bring to a consultation are varied and often vague. This research highlights the importance of communication to elicit, identify and address the issues of importance to people in clinical encounters to ensure a positive experience and outcome for both the individual person and clinician. Tweetable AbstractAchieving desirable health outcomes is more likely when people are supported to think about their priorities and ‘what matters to them’.