The Experience of "Problem" Patients as Experienced by Senior Physiotherapists in the Context of their Working Lives

Abstract

The quality and effectiveness of physiotherapy is influenced by the nature of the relationship between health professional and patients. This can be seriously disrupted if patients are perceived as ?problem? patients by physiotherapists. Ten senior physiotherapists joined two focus groups and seven other senior physiotherapists took part in in-depth interviews to identify how they define and respond to problem patients in the context of their working lives. Several categories of patient were identified, including those who resist the self-care approach, those who are trapped in a dependent state by society, those who want minimal involvement with the therapist, and those with exceptional healthcare needs leading to an interruption of the process and the outcome of physiotherapy. Other confounding variables were those situations in which the respondents felt unsupported leading to uncertainty and confusion and resulting in role ambiguity. The respondents were all confident of their unique knowledge and expertise and employed many coping strategies and it may be that these patients should become ?special? cases thus attracting higher status and specialist clinicians to deal with them.