What are the views of musculoskeletal physiotherapists and patients on person-centred practice? A systematic review of qualitative studies

Abstract

Purpose

There is a growing expectation of physiotherapists to adopt a person-centred approach to their practice. Person-centredness for musculoskeletal physiotherapy, however, remains an under-researched area. A synthesis of the findings from qualitative studies exploring perceptions of person-centredness in musculoskeletal physiotherapy was conducted to inform future clinical practice.

Methods

ENTREQ and PRISMA guidelines were used to develop a protocol for a qualitative systematic review registered with PROSPERO (registration number: CRD42020170762). Five electronic databases were searched to identify relevant primary studies. Studies were assessed for quality and data extracted. Data were analysed using thematic synthesis.

Results

A total of 3250 studies were identified and screened. Nine studies met the inclusion criteria. Four main themes emerged from the data: treating each patient as a unique person, the importance of communication for achieving a therapeutic alliance, necessary physiotherapist traits for person-centredness, and supporting patient empowerment.

Conclusion

Empowerment of patients in musculoskeletal physiotherapy contexts might be improved through a more narrative approach to assessment, with clinical bravery recognised as a specific person-centred physiotherapy trait able to facilitate this. Physiotherapists should also consider the meaningfulness of any treatment activities they provide to maximise the person-centredness of their approach.

IMPLICATIONS FOR REHABILITATION

• Empowerment of patients in musculoskeletal physiotherapy contexts might be improved through a more narrative approach to assessment.

• Clinical bravery is a person-centred physiotherapy trait that facilitates certain conversational freedom to elicit the true patient narrative.

• Person-centred physiotherapists should reflect on how meaningful their treatment activities are for individual MSK outpatients.

Keywords:

• Person-centred practice
• physiotherapist
• musculoskeletal
• metasynthesis
• qualitative research

Disclosure statement

The author reports no conflicts of interest.