WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
and lower disability in mobilization, and the absences of
neurological signs and symptoms in training.
Implications: There is evolving support for some clinical
variables and aspects of the construct of the TSB classifica-
tion system.
Keywords: Sub-grouping; clinical practice; treatment
Funding acknowledgements: Grateful thanks to the
Ann-Marie and Ragnar Hemborg foundation for financial
support of this study.
Ethics approval: The Regional Ethics committee in
Stockholm approved the study (Dnr 2014/851-32).
http://dx.doi.org/10.1016/j.physio.2015.03.1645
Research Report Platform State of the Art Presentation
Number: RR-PLSoA-2085
Saturday 2 May 2015 16:00
Hall 405
PATIENT-CENTERDNESS IN
PHYSIOTHERAPY: WHAT DOES IT ENTAIL?
A SYSTEMATIC REVIEW OF QUALITATIVE
STUDIES
A.J. Wijma 1,2,3,4 , A.N. Bletterman 5 ,
S.C.J.M. Vervoort 6 , A.J. Beetsmax 7 ,
C.P. van Wilgenx 1,3,4
1 FreeUniversity of Brussels, Department of Physiotherapy
and Rehabilitation Sciences, Brussels,
Belgium; 2 University of Utrecht, Student Physical Therapy
Research, Utrecht, The Netherlands; 3 Transcare,
Transdisciplinary Painmanagement Center, Harkema, The
Netherlands; 4 Pain in Motion Research Group, Brussels,
Belgium1 ; 5 University of Utrecht, Student Physical
Therapy Research, Program in Clinical Health Sciences,
Utrecht, The Netherlands; 6 University of Utrecht,
Department of Internal Medicine and Infectious Diseases,
Utrecht, The Netherlands; 7 Hanze University of Applied
Sciences, School of Health Studies, Department of
Physiotherapy, Groningen, The Netherlands
1 www.paininmotion.be.
Background: Patient-centeredness has been defined in
multiple ways in medicine, nursing and occupational ther-
apy. In physiotherapy however, although some qualitative
research has been done, there is not yet a clear overall defini-
tion on patient-centeredness. This is an omission, as physical
therapy evolves more around the patients and their behavior
and perceptions.
Purpose: Therefore the aim of this study was to clearly
identify the definition of patient-centeredness in physiother-
apy. As well as provide a framework of patient-centredness
in physiotherapy.
eS1627
Methods: A systematic search was conducted in PubMed,
EMBASE, Cochrane, PsychINFO, CINAHL, PEDro and
Scopus including articles from September 5th 2014. All arti-
cles were examined for eligibility. Methodological quality
was examined by a checklist based on the COREQ statement
for qualitative research, checklist by Schoeb et al. and check-
list of the BMJ. The studies were examined for either a model
or factors of patient-centeredness in physiotherapy. Data was
extracted using a data extraction form and analyzed following
‘thematic synthesis’.
Results: The search provided 641 articles of which 13
articles were included. Methodological quality was high in 3
out of 10 studies. Through analysis 13 primary themes were
identified, and gathered into 6 major descriptive themes and
7 subcategories. The descriptive themes were:
The role of the physiotherapist (with subcategories Social
characteristics, Confidence and Knowledge) is described as
the role the physiotherapist adapts to center place the patient,
including the belonging characteristics. A patient-centered
physiotherapist should be respectful, open, confident and
competent.
Communication (with subcategory Non-verbal communi-
cation) was the need of an ongoing dialogue with patients
in clear and lay speech. This requires openness of the thera-
pist about themselves and the therapy, and ultimately creates
safety for the patient to open up.
Education primarily involves advice about physical symp-
toms, the problem, the diagnosis, the treatment, the treatment
course, and the explanation of the assessment process.
Goal setting: Patient-centered physiotherapists try to
allow the patients to define their own goals.
Individuality (with subcategory Getting to know the
patient, Individualized treatment) concerns specific patient-
tailored education, communication and treatment. It is
important to get to know the patients’ history, needs, prefer-
ences, personality, beliefs, values, motivation, circumstances
and individualize treatment according this.
The last found theme was Support (with subcategory
Empowerment), this consists of a mixture of individuality,
equality of responsibility, understanding, feeling important,
reassuring, and empowerment. Patients valued the feeling of
a physiotherapist having their back.
Conclusion(s): Patient-centeredness in physiotherapy
involves the characteristics of a reflective patient-centered
physiotherapist. This includes
(a) the need for ongoing individual dialogue in lay speech
as well as in advice,
(b) individualized education,
(c) setting patient-bound goals in collaboration with the
patient,
(d) that the patient feels supported. Patient-centeredness is
complex, dynamic and the themes found are interactive.
eS1628 WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Implications: The outcomes of this review can be used as
a guide for physiotherapists and students.
Keywords: Patient-centeredness; qualitative studies; sys-
tematic literature review
Funding acknowledgements: This study was unfunded.
Ethics approval: This study was conducted complying
with the Dutch law and international principles on research
involving human subjects.
http://dx.doi.org/10.1016/j.physio.2015.03.1646
Research Report Platform Rapid 5 Presentation
Number: RR-PLR5-2092
Monday 4 May 2015 15:45
Room 324–326
WHAT IS IMPORTANT IN PAIN
NEUROSCIENCE EDUCATION? THE
EXPERIENCE OF PATIENTS WITH
CHRONIC PAIN
A.J. Wijma 1,2,3,4 , A. Crom-Ottens 2 ,
C.M. Knulst-Verlaan 2 , D. Keizer 3 ,
J. Nijs 4,5,6 , C.M. Speksnijder 7,8,9 ,
C.P. van Wilgen 3,4,10
1 FreeUniversity of Brussels, Department of Physiotherapy
and Rehabilitation Sciences, Brussels,
Belgium; 2 University of Utrecht, Student Physical Therapy
Research, Program in Clinical Health Sciences, Utrecht,
The Netherlands; 3 Transcare, Transdisciplinary
Painmanagement Center, Harkema, The
Netherlands; 4 Pain in Motion Research Group, Brussels,
Belgium1 ; 5 Free University Brussel, Department of
Physiotherapy and Rehabilitation Sciences, Faculty of
Physical Education and Physiotherapy, Brussels,
Belgium; 6 Free University Brussel, Department of Human
Physiology Faculty of Physical Education and
Physiotherapy, Brussels, Belgium; 7 University of Utrecht,
Physical Therapy Science, Program in Clinical Health
Sciences, Utrecht, The Netherlands; 8 University of
Utrecht, Department of Oral and Maxillofacial Surgery and
Special Dental Care, Ureterp, The Netherlands; 9 Radboud
University Nijmegen Medical Centre, Scientific Institute for
Quality of Health Care, Nijmegen, The
Netherlands; 10 Free University of Brussels, Department of
Physiotherapy and Rehabilitation Sciences, Faculty of
Physical Education and Physiotherapy, Brussels, Belgium
1 www.paininmotion.be.
Background: There is a large number of studies exam-
ining the effect of PNE in chronic pain disorders, these
studies have found a positive influence on knowledge of pain
and pain perceptions; decreased pain and pain inhibition;
improved physical functioning; a diminished passive coping,
kinesiofobia and catastrophizing. However, the thoughts and
beliefs of patients regarding PNE are unknown. In a treatment
that addresses patient’s perceptions it is important to know
what these patient’s thoughts and beliefs are.
Purpose: The purpose of this study was to understand how
patients experience pain neuroscience education.
Methods: Fifteen patients with chronic pain at a trans-
disciplinary treatment center were interviewed. Patients who
receive treatments here have a three hour assessment; one
hour physiotherapist, psychologist, general practioner. One
week after this intake patients are seen by the general prac-
tioner. If specific illnesses and nociceptive causes for pain
are ruled out patients are diagnosed with sensitization. They
receive a short verbal neuroscientific description of sensitiza-
tion and a booklet. Approximately one week later the patient
receives pain neuroscience education by both the psycholo-
gist and the physiotherapist. Afterwards, treatment options
are discussed and if necessary deployed, with either medica-
tion, physiotherapy, psychotherapy, or a combination.
Member checks were performed, furthermore a focus
group with healthcare professionals from the transdisci-
plinary treatment center was conducted. Interviews were
transcribed verbatim. Analysis was done according to
Grounded Theory and the QUAGOL.
Results: Four interacting concepts emerged.
Fundamentals: this involves the primary needs to provide
pain neuroscience education; a biopsychosocial intake
before the education, although emotionally exhausting, gives
patients a connection with the healthcare professionals and
starts a process of awareness. Furthermore, the interpersonal
aspects of healthcare professionals are important. Such as;
being friendly, serious, interested, involved, open, creating
an open interaction, being expert in the field of pain.
Comprehensibility: the explanation is in understandable
pain language. The booklet received with the drawings is clar-
ifying. Especially the burglary/fire alarm. Repetition of pain
neuroscience education by the booklet, drawings and pain
neuroscience session is important. The interaction between
healthcare professionals during the education improves the
comprehensibility.
These concepts influence the outcomes: there is an
increased awareness by the respondents; they gained insights
in their complaints and their perceptions of pain changed, they
were more conscious of their behavoir, gained self-control
over their symptoms. Some found peace of mind, some did
not get reassured, some experienced fewer complaints, others
did not.
Scepticism: apparent doubt towards sensitization was
found to be normal, some respondents rejected the expla-
nation.
Conclusion(s): This study illuminates the perceptions of
patients receiving pain neuroscience education. The intake
and good interpersonal factors of the healthcare professionals
enhances the alliance and, together with the clear explanation,
improves the outcomes.