Exploring the meaning of the biopsychosocial approach in the management of musculoskeletal conditions: Patients’ and physiotherapists’ perspective
Julkaistu sarjassa
JYU dissertationsTekijät
Päivämäärä
2021Tekijänoikeudet
© The Author & University of Jyväskylä
Despite an increasing amount of treatments and health care resources being devoted to them, musculoskeletal conditions continue to be the greatest health burden globally. The biopsychosocial approach is starting to be widely accepted in the field of musculoskeletal care and the main guidelines recommend its use, but its implementation in clinical practice is not without challenges.
The aim of this dissertation was to explore the meaning of the biopsychosocial approach in the management of musculoskeletal conditions from the perspectives of patients and physiotherapists. The four scientific articles of this dissertation used qualitative methods. Two of the phenomenographic studies focused on the conceptions of low back pain patients and one on those of physiotherapists, captured through individual semi-structured interviews. In addition, a systematic review and metasynthesis of qualitative studies was conducted which focused on physiotherapists’ perceptions of learning and implementing biopsychosocial interventions.
The findings showed that the patients’ conceptions of health care encounters and undergoing physiotherapy in the Finnish health care system both before and after the physiotherapists received brief training in Cognitive Functional Therapy varied from non-encounters and being left empty-handed to life-changing and holistic encounters that supported their autonomic agency and self-management of low back pain. The physiotherapists' perceptions of learning and implementing the biopsychosocial approach expanded from recognizing the difference of the new approach to creatively applying their new skills. Five common themes of understanding the meaning of the biopsychosocial approach in the management of musculoskeletal conditions emerged from the patients’ and physiotherapists’ perceptions: the difference of the new approach, understanding pain, patient-centered care, gaining confidence, and support.
The stepping stones identified in this dissertation can be used to create more meaningful physiotherapy for patients with musculoskeletal conditions and more meaningful training for physiotherapists in order to offer better support in learning and implementing the biopsychosocial approach in clinical practice.
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Julkaisija
Jyväskylän yliopistoISBN
978-951-39-8652-0ISSN Hae Julkaisufoorumista
2489-9003Julkaisuun sisältyy osajulkaisuja
- Artikkeli I: Holopainen, R., Piirainen, A., Heinonen, A., Karppinen, J., & O'Sullivan, P. (2018). From "Non-encounters" to autonomic agency : Conceptions of patients with low back pain about their encounters in the health care system. Musculoskeletal Care, 16(2), 269-277. DOI: 10.1002/msc.1230
- Artikkeli II: Holopainen, R., Vuoskoski, P., Piirainen, A., Karppinen, J., & O’Sullivan, P. (2020). Patients’ conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy. Disability and Rehabilitation, Ahead of Print. DOI: 10.1080/09638288.2020.1861116
- Artikkeli III: Holopainen, R., Piirainen, A., Karppinen, J., Linton, S. J., & O’Sullivan, P. (2020). An adventurous learning journey : Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice. Physiotherapy Theory and Practice, Early online. DOI: 10.1080/09593985.2020.1753271. JYX: jyx.jyu.fi/handle/123456789/70960
- Artikkeli IV: Holopainen, R., Simpson, P., Piirainen, A., Karppinen, J., Schütze, R., Smith, A., O’Sullivan, P., & Kent, P. (2020). Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions : a systematic review and metasynthesis of qualitative studies. Pain, 161(6), 1150-1168. DOI: 10.1097/j.pain.0000000000001809. JYX: jyx.jyu.fi/handle/123456789/68279
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Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions : a systematic review and metasynthesis of qualitative studies
Holopainen, Riikka; Simpson, Phoebe; Piirainen, Arja; Karppinen, Jaro; Schütze, Rob; Smith, Anne; O’Sullivan, Peter; Kent, Peter (Lippincott Williams & Wilkins, 2020)Clinical practice guidelines recommend a biopsychosocial approach for the management of musculoskeletal pain conditions, but physiotherapists have reported feeling inadequately trained and lacking in confidence to deal ... -
Biopsychosocial Profiles of Patients With Cardiac Disease in Remote Rehabilitation Processes : Mixed Methods Grounded Theory Approach
Anttila, Marjo-Riitta; Soderlund, Anne; Paajanen, Teemu; Kivistö, Heikki; Kokko, Katja; Sjögren, Tuulikki (JMIR Publications Inc., 2021)Background: Digital development has caused rehabilitation services and rehabilitees to become increasingly interested in using technology as a part of rehabilitation. This study was based on a previously published study ... -
Patient education in physiotherapy in total hip arthroplasty (THA) : The perspective of physiotherapists
Jäppinen, Anna-Maija; Hämäläinen, Harri; Kettunen, Tarja; Piirainen, Arja (Taylor & Francis, 2020)Background and Purpose There is limited knowledge about patients’ and physiotherapists’ perceptions of patient education in physiotherapy in hip arthroplasty. The aim of this study was to describe physiotherapists’ ... -
An adventurous learning journey : Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice
Holopainen, Riikka; Piirainen, Arja; Karppinen, Jaro; Linton, Steven James; O’Sullivan, Peter (Taylor & Francis, 2022)Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. ... -
Clinical reasoning and critical reflection in physiotherapists’ examinations of patients with low back pain in its early phase : a qualitative study from physiotherapists’ point of view
Karvonen, Eira; Paatelma, Markku; Laitinen-Väänänen, Sirpa; Piirainen, Arja (Taylor & Francis; Informa Healthcare, 2017)Aim: The aim of this study was to deepen the current understanding of physiotherapists’ decision-making process and more specifically, to investigate their reflections on their clinical reasoning when examining low back ...
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