[Truncated abstract] This PhD project was comprised of three major studies. Study 1 utilised the Nominal Group Technique (NGT) to identify a typology of difficult patients in private practice physiotherapy and to determine strategies physiotherapists use and would like to improve, when dealing with such patients. Physiotherapists (n=37) also shared their expectations of patients and their perceptions of patient expectations of physiotherapy. Results showed that the two areas most difficult to manage were behavioural problems of patients followed by patient expectations. To assist in their interaction with difficult patients, physiotherapists identified communication skills and behaviour modification techniques as strategies they would most like to learn. While physiotherapists expressed the greatest number of expectations in the behavioural domain, identification of patient expectations was not elicited as a strategy to manage difficult patients. Results of this qualitative study contribute to the evolving literature relating to physiotherapist-patient interactions and form a useful basis for educational programs directed at improving the therapeutic relationship in private practice physiotherapy. Study 2 involved applying the NGT with separate groups of patients (n=26) to identify patient expectations of the qualities of a ‘good’ physiotherapist, and to ascertain the characteristics of good and bad experiences in private practice physiotherapy. Findings indicated that the qualities of a ‘good’ physiotherapist related to their communication ability, professional behaviour and organisational ability, and characteristics of the service provided. The most important expectations of patients were for example, symptomatic relief, self-management strategies and ‘hands on’ treatment; associated with the physical domain. When comparing equivalent groups from Study 1, with patient expectations, most patient groups identified that the most important expectations of physiotherapists would relate to patient behaviours such as; compliance, honesty, payment of their account, being punctual, cooperating, trusting and showing respect for their physiotherapist. However, physiotherapists’ rankings of the most important expectations held by patients were not congruent with patient rankings providing an explanation as to why problems may arise in the physiotherapistpatient interaction from the patient’s perspective. Based on the findings of Study 2 it was suggested that physiotherapists should actively seek to involve patients in their management. To do this effectively, physiotherapists would benefit from further training in communication skills to ensure that they can successfully adopt a patientcentred approach and to optimise the physiotherapist-patient interaction in private practice physiotherapy.
|Qualification||Doctor of Philosophy|
|Publication status||Unpublished - 2003|