Physiotherapists’ experiences of adopting an eTool in clinical practice: a post-phenomenological investigation

Figures & data

Table 1. Outline of elements in «The FYSIOPRIM»

Name of Entry in App	Description or Wording in App	Response Option and Scoring in App
Demographics
Sex	Patient’s sex	Female; Male
Age	Patient’s age	Age in years
Referral	Is the patient referred?	Y/N
ICPC code	Category and code	Therapist may add free text
Referral, detailed	Who referred the patient?	List of options
Complaint	Why is the patient seeing a physiotherapist?	List of options
Date of referral	Date the patient was referred to physiotherapy	Date (dd/mm/yyyy)
Date of first appointment	Date of first appointment w/physiotherapist	Date (dd/mm/yyyy)
Waiting time	How long has it been since the patient contacted a physiotherapist for an appointment?	˂1 week 1–2 weeks 2–4 weeks 4 w-3 months			3–6 months 6–12 months ˃1 year
Priority assignment	The physiotherapist’s priority assignment (1–4)	1.Quick start of intervention is essential and waiting time will lead to negative consequences 2. Good treatment outcome is associated with early intervention 3. Intervention is expected to have good effect, but start of treatment can wait up to 1 month 4. Intervention is expedient for maintenance and improvement of activities of daily living, but start of intervention can wait without any significant consequences.
Body regions	Mark the relevant body region(s) for your complaint (multiple answers possible)	Head Jaw Columna Neck Thorax Low back Pelvis	Tailbone Shoulder Hand Hip Knee Ankle/foot Widespread/complex pain
Comorbidity	Specify diagnosis (if applicable) (multiple answers possible)	Myalgia Tendinopathy Pain ≥6 months Mental health Arthrosis Rheumatology Heart disease Asthma/lung Stroke Neurology Cancer	Lymphedema Headache/migraine Dizziness Trauma ligament Trauma fracture Trauma muscles Surgery/post-surgery rehab Elderly w/impaired function Dementia/cognitive deficit
Height and weight	Cm and kg
Smoking	Do you smoke?	Y/N
Education	Highest level of education	Primary school or lower High school Up to 4 years of college/university More than 4 years of college/university
Ethnicity	Place of birth	Norway Europe Africa Asia	North America South/middle America Oceania
Marital status		Married/cohabitant Divorced Widow/widower Single
Living situation		Lives in own home alone Lives in own home with others Lives in institution
Care of children	How many children under 18 years are in your daily care?	Number of children
Network, support	1. Do you have family or friends who can offer you help when needed? 2. Do you have family and friends with whom you can talk confidentially?	Y/N Y/N
Health services	Have you had treatment for your complaints during the last 12 months?	No General practitioner Physician, specialist Chiropractor Manual therapist Physiotherapist	Psychomotor physiotherapist Psychologist Alternative/complementary therapist
Main goal	Main treatment goal (set by patient/therapist collaboration, evaluated at follow-up)	Free text
Planned treatment	Treatment planned to reach main goal (set by patient/therapist collaboration, compliance evaluated at follow-up)	Free text
Disability and Function
Diagnosis by therapist	Functional diagnosis defined by the therapist	Free text
PSFS	Patient Specific Functional Scale; 3 activities identified by the patient in collaboration with the physiotherapist	NRS: 0–10: 0 = unable to perform activity and 10 = no problem to perform activity
EQ5D-5L	EuroQol-health related quality of life: 5 items; mobility, self-care, usual activities, pain, anxiety/depression	Each item has 5 response categories Summarized as index score:0–1; 0 = death and 1 = full health
15D	Health related quality of life, 15 items; mobility, vision, hearing, breathing, sleeping, eating, speech, excretion, usual activities, mental function, discomfort and symptoms, depression, vitality, sexual activity	Each item has 5 response categories Summarized as index score:0–1; 0 = death and 1 = full health
COOP/WONCA	6 items of physical fitness, feelings, daily activities, social activities, change in health and overall health	5-6 response categories varying according to item
ADL	To what extent are your activities of daily life reduced due to pain or complaints?	Very much reduced; Quite reduced; Slightly reduced; Not reduced
Walking aid	Do you use any walking aids?	Y/N
Time spent sitting	How many hours during a regular day do you spend sitting? (Both work and leisure time)	0–24 hours
Physical activity frequency	How often do you exercise during a week?	Never Once Less than once		2–3 times Approximately every day
Physical activity intensity	How intensely do you exercise?	Light without sweating and getting breathless Getting breathless and sweating Almost to complete exhaustion
Physical activity duration	For how long do you exercise each time?	Less than 15 min 15–29 min		30 min-1 hour ˃1 hour
Risk of falling	1. Previous falls last year? 2. Problems w/balance or walking? 3. Unable to get up from sitting to standing without use of hands? 4. Parkinson disease or stroke? 5. Three or more chronic diseases? 6.≥5 medications per day? 7. Reduced cognitive function? 8. Reduced vision? 9. Body mass index ˂20? 10. Fear or worry of falling?	Question 1–9:Y/N		Question 10: Not at all worried Slightly worried Quite worried Very worried
Floor to standing mobility	1. Can you get down on the floor on your own? 2. Can you get up from the floor on your own?	Yes No Do not know
Employment/Work
Employment status	What is your current employment situation? (multiple answers possible)	Paid work Student Retired Disability pension		Work allowance pension Non-paid work Unemployed
Employment %	Specify the percentage of employment	0–100%
Sick leave %	Specify the percentage of sick leave	0–100%
Disability pension %	Specify the percentage of disability pension	0–100%
Work ability index – 1 item	What is your current work ability compared with the lifetime best?	NRS: 0–10; 0 = cannot work and 10 = working at best
Pain
Current pain intensity	Mark the number that indicate your current pain intensity	NRS: 0–10; 0 = no pain and 10 = worst imaginable pain
Pain intensity last week	Item 2 from Ørebro Screening Questionnaire: How would you rate the pain that you have had during the past week?	NRS: 0–10; 0 = no pain and 10 = worst imaginable pain
Pain duration	Item 1 from Ørebro Screening Questionnaire: How long have you had your current pain problem?	0–1 week 1–2 weeks 3–4 weeks 4–5 weeks 6–8 weeks		9–11 weeks 3–6 months 6–9 months 9–12 months >1 year
Pain drawing	“Mark areas in the body drawing where you have pain”	Total of marked areas, range: 0–112
Temporal aspects of pain	1. Is the pain continuous? 2. Does the pain intensity vary? If yes on 2: 3. Describe the temporal aspects of the pain:	Yes, I can feel it all the time; No, it is on and off Yes; No, it is stable It varies during the day and night; It varies from day to day; Other
Onset of complaint	How was the onset of your complaints?	Acute Gradually
Analgesics	Have you used pain medication the last week? If yes: What medicines? (Three categories defined from active ingredient: Based on paracetamol, acetylsalisyl acid or ibuprofen)	Yes; No 1. Paracetamol, Paracet, Panodil, Pimol, Pinex or Perfalgan 2. Albyl-E (500 mg), Aspirin, Bloboid or Dispril 3. Ibuprofen, Ibux, Ibuprox, Ibumetin, Brufen, Naproxen, Naprosyn 4. Others
Medicines	Daily medicine intake	0; 1–4; or 5 or more
Psychosocial Factors
HSCL-10	Hopkins Symptom Check List; 10 item version	Range: 1–4; 1 = not at all and 4 = very much (extremely), mean item score is calculated
Fear of movement	Single item: How much fear do you have that these complaints would be increased by physical activity?	NRS: 0–10; 0 = no fear and 10 = very much fear
Tampa	Tampa Scale of Kinesiophobia; 13 item version	Range: 13–53; higher score indicates higher level of kinesiophobia
Ørebro-10 item	Ørebro Screening Questionnaire; 10 item version	Range: 0–100; higher score indicates higher levels of estimated risk for developing pain related disability
Pain self efficacy	Pain Self Efficacy Questionnaire; 2 items: 1. I can do some form of work, despite pain (work includes housework and paid/unpaid work) 2. I can live a normal lifestyle, despite pain	Range: 0–6; 0 = not at all confident and 6 = completely confident, total range: 0–12; higher score indicates higher level of self-efficacy
Treatment expectancy	I believe physiotherapy will improve my function	Totally agree; Agree; Neither agree nor disagree; Disagree; Totally disagree
BACQ	The Brief Approach/Avoidance Coping Questionnaire	Range: 1–5; 1 = disagree completely and 5 = agree completely, higher score indicates use of more approach-oriented coping strategies
Family and friends	1. Do you have family or friends that can give you help when needed? 2. Do you have family and friends with whom you can talk confidentially?	Y/N Y/N
Short FES-I	The Short Falls Efficacy Scale-Internationally	Range: 7–28; higher score indicates severe concern about falling
Disease – or Region Specific Questionnaires
NDI	Oswestry Disability Index	Range: 0–100; 0 = no disability and 100 = 100% disability
STarTBack	Keele STarTBack screening tool, subgrouping of patients into 3 a priori treatment options	Range: 0–9 points, categorization into risk groups based on the scoring
Hannover	Hannover Functional Ability Questionnaire; 12 items	Range: 0–24; higher score indicates poorer function
SPADI	Shoulder Pain and Disability Index	Range: 0–100; 0 = no disability and 100 = 100% disability
Quick-DASH	Shortened version of the Disabilities of the Arm, Shoulder and Hand Score; 11 items	Range: 0–100; 0 = no disability and 100 = 100% disability
PGQ	Pelvic Girdle Questionnaire; 25 items	Range: 0–100; 0 = no problem and 100 = to a large extent
HOOS	The Hip Disability and Osteoarthritis Outcome Score	Sub scores for five domains: 1) Pain: 0–100; 2) Symptoms: 0–100; 3) ADL: 0–100; 4) Sports/Recreation: 0–100; and 5) QOL: 0-100
KOOS	The Knee injury and Osteoarthritis Outcome Score	Sub scores for five domains: 1) Pain: 0–100; 2) Symptoms: 0–100; 3) ADL: 0–100; 4) Sports/Recreation: 0–100; and 5) QOL: 0-100
OA-QI	Arthrosis Quality Indicator; 17 questions about treatment alternatives for osteoarthritis	3 response categories; yes, no and a third that varies between the questions, pass rates for each question are calculated and used as a quality indicator
PCS	Pain Catastrophizing Scale	Range: 0–52; higher score indicates higher level of catastrophizing
Physical functioning from SF-36	10 items of physical functioning from SF-36 related to activities in daily life	Range: 1–3 for each item; 1 = yes, limited a lot and 3 = no, not limited at all, domain score range: 0–100%; higher score indicates better function
Vitality from SF-36	4 items of vitality from SF-36 related to activities in daily life	Range: 1–6 for each item; 1 = all the time and 6 = not at all, domain score range: 0–100%; higher score indicates better function
ISI	Insomnia Severity Index; 7 items	Range: 0–4 for each item; 0 = not at all and 4 = extremely, total range: 0–28; higher score indicates greater insomnia severity
Norwegian questionnaire for the assessment of body experience	64 items; 11 subscales of body awareness, body contact, body endurance, body satisfaction, balance, breathing, aversion, tension, bodily discomfort, distance/remoteness and physical distance/boundaries	Range: 1–6 for each item; 1 = never and 6 = all the time (scores for some items are reversed), subscale scores are mean of item scores within the subscale
Evaluation of Treatment
GPE	Global Perceived Effect (1–7)	1 = very much better 2 = much better 3 = slightly better 4 = neither better nor worse		5 = slightly worse 6 = much worse 7 = very much worse
Fulfillment of treatment expectations	To what extent were your expectations to physiotherapy fulfilled?	To a very large extent; To a large extent; To some extent; To a little extent; To a very little extent
Benefit of treatment	To what extent have you benefited from physiotherapy?

Note: The above listed items are a description of questions and questionnaires in the FYSIOPRIM. The FYSIOPRIM also comprises clinical tests and other items not listed here. For a comprehensive description, see Evensen KA, Robinson HS, Meisingset I, Woodhouse A, Thielemann M, Bjorbækmo WS, Myhre G, Hansen AE, Vasseljen O, Vollestad NK 2018 Characteristics, course and outcome of patients receiving physiotherapy in primary health care in Norway: design of a longitudinal observational project. BMC Health Services Research 18: 936.