Article

Cognitive functional therapy (CFT) has been shown to reduce pain and
disability in people with chronic low back pain. OBJECTIVES:
The purpose of this
study was to investigate participants' experience of CFT by comparing
participants who reported differing levels of improvement after participation in
CFT, potentially yielding insight into the implementation of this approach.
DESIGN: This was a noninterventional, cross-sectional, qualitative study with an
interpretive description framework. METHODS: Individuals who had participated in
CFT in 2 physical therapy settings (in Ireland and Australia) were recruited
through purposive sampling based on disability outcomes postintervention (n=9),
and theoretical sampling (n=5). This sampling strategy was used to capture a
range of participant experiences but was not used to define the final qualitative
groupings. Semistructured interviews were conducted 3 to 6 months
postintervention. RESULTS: Three groups emerged from the qualitative analysis:
large improvers, small improvers, and unchanged. Two themes encapsulating the key
requirements in achieving a successful outcome through CFT were identified: (1)
changing pain beliefs and (2) achieving independence. Changing pain beliefs to a
more biopsychosocial perspective required a strong therapeutic alliance,
development of body awareness, and the experience of control over pain.
Independence was achieved by large improvers through newly cultivated
problem-solving skills, self-efficacy, decreased fear of pain, and improved
stress coping. Residual fear and poor stress coping meant that small improvers
were easily distressed and lacked independence. Those who were unchanged
continued to feel defined by their pain and retained a biomedical perspective.
CONCLUSIONS: A successful outcome after CFT is dependent on instilling
biopsychosocial pain beliefs and developing independence among participants.
Small improvers may require ongoing support to maintain results. Further study is
needed to elucidate the optimal approach for those who were unchanged.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS