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Published on: December 13, 2024
Therapeutic Alliance: Patients' Expectations Before and Experiences After Physical Therapy for Low Back Pain-A
Monica Unsgaard-Tøndel1,2,3, Sylvia Søderstrøm1
1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Objective:
The aim of this study was to explore patients' expectations before and experiences after physical therapy for low back pain.
Methods:
Qualitative in-depth, semi-structured interviews with patients attending physical therapy were performed before, immediately after, and 6 months after treatment. Data were analyzed from a hermeneutical perspective with decontextualization, recontextualization, and identification of themes.
Results:
Patients' pretreatment expectations to physical therapy focused around exercises and a body-oriented diagnosis. After treatment, reassurance, active listening with explanations, and personally adapted strategies for self-managing pain and regaining control over everyday activity were expressed as decisive for a meaningful therapeutic alliance.
Conclusion:
Expectations before treatment focused on exercises and diagnosis. Empathetic and personally adapted education aimed at empowerment was experienced as a meaningful aspect of the therapeutic alliance after treatment. The therapeutic alliance provided a basis to integrate knowledge on the complexity of pain.
Impact:
Our findings indicate that patients emphasize physical therapists' interactional and pedagogical skills as meaningful aspects of the therapeutic alliance, which has implications for clinical practice and training physical therapist students.
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