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- Lundvik Gyllensten, Amanda, et al.
(författare)
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Interaction between patient and physiotherapist in psychiatric care-the physiotherapist perspective
- 2000
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 2:4, s. 157-167
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate what factors the physiotherapy experts in psychiatric physiotherapy believed to be important in the interaction between the patient and the physiotherapist (PT). The objective was to obtain a deeper insight into their reasoning concerning interaction and treatment outcomes. Eleven nominated ''expert'' PTs were each interviewed twice. Triangulation of important events, an exemplar (critical incident) and a key informant interview were used in the data collection. A qualitative design with crosscase analysis was used in the data analysis. Important interaction factors were divided into a ''prerequisites dimension'', ''interaction dimension'' and ''outcome dimension''. In the prerequisites dimension there were three themes: ''prerequisites of the PT'', ''prerequisites of the patient'' and ''external factors''. In the interaction dimension there were also three themes: ''ways of contact'', ''therapeutic process'' and ''structure of treatment''. In the outcome dimension the theme ''outcome'' and the two categories ''patient - awareness of own resources and ''PT - improvement of interaction skills with the aid of reflection'' were found. Interaction was considered to be important for the outcome and for the patient's awareness of his:her resources. The body awareness skills of the PT, the therapeutic relationships, help for the patient to identify his:her resources and the contract were also important. The ability to be fully mentally present in the encounter and the use of non-verbal skills were emphasized. Supervision and reflection about the outcome increased the PT's interaction skills in a learning process. The physiotherapy process expressed was resource-oriented.
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| 2. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Outcome of Basic body awareness therapy. A randomized controlled study of patients in psychiatric outpatient care
- 2003
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 5:4, s. 179-190
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the outcome of Basic Body Awareness Therapy (Basic BAT) added to treatment as usual (TAU) compared to TAU only, for patients with mood, somatoform or personality disorders in psychiatric outpatient services. Seventy-seven patients were randomized to Basic BAT and TAU (n=38) or TAU only (n=39). Patients were assessed at baseline and after 12 sessions of Basic BAT, 3 months after baseline. At the termination of Basic BAT sessions, patients receiving Basic BAT in addition to TAU showed significant improvements concerning the quality of movements using the Body Awareness Scale-Health (BAS-H), and psychiatric symptoms and attitudes towards body and movement using the Body Awareness Scale interview, compared to the TAU-only patients. A significant improvement in favour of the patients receiving Basic BAT was also shown with regard to self-efficacy, physical coping resources and sleep. Age and sex showed no significant influence on outcome. The results indicate that Basic BAT in addition to TAU, in a relatively short intervention period improves the body awareness and attitude towards the body as well as self-efficacy, sleep and physical coping resources compared to TAU only. This study indicates a positive short-term outcome of the Basic BAT treatment. However, studies of the long-term outcome remain to be undertaken.
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| 3. |
- Gyllensten, Amanda Lundvik, et al.
(författare)
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Long-term effectiveness of basic body awareness therapy in psychiatric outpatient care. A randomized controlled study
- 2009
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 11:1, s. 2-12
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Tidskriftsartikel (refereegranskat)abstract
- The long-term effects of Basic Body Awareness Therapy (BBAT) in addition to treatment as usual (TAU) were studied in a randomized, controlled design in psychiatric outpatient care. Seventy-seven patients with mood, stress-related somatoform, behavioural or personality disorders were studied at baseline, after a 3-month treatment period and at a 6-month follow-up. The use of psychiatric healthcare and social services were studied during 12 months, starting with baseline. The study comprised a control group (n=39) that received TAU and a treatment group (n=38) that in addition to TAU also received 12 sessions of BBAT. The aim was to study the effects of BBAT in addition to TAU compared with TAU only, regarding: body awareness, health-related factors and coping strategies as well as the use of the social services and psychiatric healthcare. Analysis of variance (ANOVA) repeated-measures analysis of the intention-to-treat population (n=77) revealed that the BBAT group had a significantly improved body awareness (p<0.001), attitude to the body fewer symptoms (p<0.001) and improved self-efficacy (p<0.05), from baseline to 6 months after the termination of treatment, compared with the control group. The treatment group also had a significantly less use of psychiatric treatment from healthcare professionals other than the psychiatrist (p<0.05) during 1 year after baseline and a significantly less total use of social services (p<0.05). The evidence of the positive effects as well as the lower costs for psychiatric healthcare and social services for the group that had received BBAT in addition to TAU is discussed, and it is concluded that BBAT seem an effective intervention in psychiatric outpatient care also in the long term for patients who in addition to psychiatric disorders also present somatic symptoms.
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| 4. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Interaction between patient and physiotherapist: a qualitative study reflecting the physiotherapist's perspective
- 1999
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Ingår i: Physiotherapy Research International. - : Wiley. - 1358-2267 .- 1471-2865. ; 4:2, s. 89-109
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose The interaction between patient and physiotherapist (PT) is central in physiotherapeutic treatment. The purpose of this study was to investigate expert physiotherapists' perception of important factors influencing the quality of the interaction in physiotherapeutic treatment. Method Ten experienced PTs working in primary healthcare were interviewed twice, triangulating a sort of important events, an exemplar and a key informant interview. The data were transcribed, coded and analysed for main themes and categories according to the qualitative technique described by Shepard et al. (1993) and Merriam (1988). Results Important factors in interaction could be divided into the Prerequisites dimension and the Interaction dimension. In the former, the most dominant theme was Internal prerequisites of the PT. The most-cited category in this theme was Practical professional skills and patient experience. In the latter, the themes Establishing contact, Ways of contact, Frames and the Therapeutic process emerged. Here, the most-cited categories were Establishing contact and confidence, having a Therapeutic role, Being sensitive and intuitive, Encountering, Listening and Identification of patient resources. These factors were seen as essential for promoting a positive patient outcome. Interaction skills were reinforced by reflection on patients' experiences. Conclusions Interaction skills of the expert PT were thought to enhance the resources of the patient and lead to a positive patient outcome. Within professional development more emphasis ought to be put on reinforcing the reflective process of the PT, for instance by the use of supervision by an experienced colleague.
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| 7. |
- Winkel, Annette, et al.
(författare)
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Early discharge to therapy-based rehabilitation at home in patients with stroke. A systematic review
- 2007
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Ingår i: Physical Therapy Reviews. - 1743-288X .- 1083-3196. ; 13:3, s. 167-187
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Tidskriftsartikel (refereegranskat)abstract
- Early discharge and home rehabilitation (EDHR) for stroke patients seems logical as an alternative to rehabilitation in stroke units, as these patients often show impaired ability to perform activities of daily living. The objective of this review is to present the effects of EDHR for stroke patients on health, quality of life and costs, and to describe the physiotherapy provided. Seventeen randomised controlled trials were included, assessed with the PEDro scale and rated using Sackett's rules of scientific evidence. The results showed that EDHR can reduce the length of time spent in hospital. It might improve basic activities of daily living, but is more likely to improve patients' instrumental activities of daily living and quality of life. The context is a core issue for the physiotherapy intervention. Early discharge and home rehabilitation seems to be cost-effective if rehabilitation at home is provided by a multidisciplinary team from a hospital. It is important to consider patients' coping capacities and possible strain on caregivers as contributing factors to the efficacy of EDHR.
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| 8. |
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| 9. |
- Petersen, Tom, et al.
(författare)
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Inter-tester reliability of a new diagnostic classification system for patients with non-specific low back pain
- 2004
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Ingår i: Australian Journal of Physiotherapy. - 0004-9514. ; 50:2, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying patients with non-specific low back pain into 12 different syndromes and three subcategories based on history and physical examination. The purpose of this study was to estimate the inter-tester reliability of clinical tests used as criteria for classifying patients. Ninety patients with chronic low back pain were each examined by two physiotherapists. A total of four physiotherapists conducted the assessments. Examination findings were recorded independently by the two examiners. Percentage of agreement and kappa coefficients were calculated for each category. The overall rate of agreement was 72% and the kappa coefficient was 0.62 for the mutually exclusive syndromes in the classification system. Agreement rates for each of the syndromes ranged from 74% to 100% and kappa coefficients ranged from 0.44 to 1.00. The findings suggest the inter-tester reliability of the system is acceptable. The relatively modest level of total agreement (39%) for the system as a whole might indicate that the utility of the system for general screening purposes is limited, compared with the utility in identification of particular syndromes. Due to low prevalence of positive findings in some of the syndromes future work should focus on testing reliability on a larger sample of patients, and testing of validity and feasibility of the system.
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| 10. |
- Grahn, B, et al.
(författare)
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Motivation for change in patients with prolonged musculoskeletal disorders : a qualitative two-year follow-up study
- 1999
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Ingår i: Physiotherapy Research International. - : Wiley. - 1358-2267 .- 1471-2865. ; 4:3, s. 89-170
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The purpose of this study was to obtain a deeper understanding of the process of motivation for change in patients with prolonged musculoskeletal disorders and to identify factors that might influence change resulting in increased independence.METHOD: A qualitative two-year follow-up study. Data collection and analysis were performed according to the qualitative case study design. An initial conceptual framework was developed to bound and guide the study. Twenty patients were selected using purposive sampling with respect to motivation level (highly motivated to less-motivated) to create a sample of maximum variation. Data were collected using repeated interviews and standardized scales. The study comprised three data collection periods.RESULTS: Motivation for change followed different processes depending on the level at entry to the study. The highly motivated patients improved in independence, the moderately motivated ones remained at an unchanged level and the less-motivated patients became more dependent. Central themes of importance to the process of motivation for change were: the utilization of professional networks (healthcare, regional social insurance office), emotional support (nuclear family, close relatives), use of personal coping resources (energy, positive beliefs, problem-solving) and social support at work (employers, colleagues).CONCLUSIONS: The performance of a structured motivation analysis, including questions about emotional networks and social support at work in addition to the clinical examination of the patient, is recommended. This might guide healthcare professionals when it comes to motivation for change in the patient.
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