Article

Purpose: To describe the approach used by a physiotherapist who led a
rehabilitation programme for injured members of the military with chronic low
back pain designed to enhance self-efficacy and self-management skills. Method:
This in-depth qualitative study used audio- and video-recorded data from
interviews and field observations. Using an inductive analysis process,
discussion of emerging themes led to a description of the physiotherapist's
approach. Results: The approach has three elements: developing a trusting
relationship through building rapport, establishing a need in patients' minds to
be actively engaged in their rehabilitation, and finding workable rehabilitation
solutions that are most likely to be adopted by individual patients. This
approach fits into current theories about health behaviour change (e.g.,
Transtheoretical Model of Change, Motivational Interviewing, Motivational Model
of Patient Self-Management and Patient Self-Management) and elements of the
therapeutic alliance. Using the therapeutic alliance (rapport) and behaviour
change techniques, the physiotherapist focused on the perceived importance of a
behaviour change (need) and then shifted to the patient's self-efficacy in the
solutions phase. Conclusions: If we recognize that rehabilitation requires
patients to adopt new behaviours, becoming aware of psychological techniques that
enhance behaviour change could improve treatment outcomes.

Langue : ANGLAIS