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Research project: Exploring communication and clinical decision-making in consultations between physiotherapists and people with back pain

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Previous research has suggested that the patient−therapist relationship is more important to success than treatment techniques. This research builds upon this work and investigates how clinical decisions are made by physiotherapists and patients with back pain, in a series of studies addressing the question: 'What communication and clinical decision−making takes place in consultations between physiotherapists and people with back pain?'In the first study patients with back pain are visited at home to find out what they expect from attending the out−patient department at Southampton. Their initial consultation is then observed and staff are interviewed about what they think they said to patients, and patients are asked about what they think they heard.In the second study, a series of physiotherapy assessment and treatment sessions are observed, recording conversations, body language and how decisions were made about patients’ care. The final study is a pilot randomized controlled trial, evaluating whether some educational workshops for physiotherapists can improved patients’ involvement in decision-making and the outcome of physiotherapy care.

The project aims to determine patients’ expectations of the physiotherapy process, since these influence both the communication that occurs, and the therapeutic relationship between the patient and physiotherapist.

Explore concurrence between physiotherapists’ and patients’ perceptions of diagnosis and treatment.

 Describe the verbal and non-verbal communication occurring during the therapeutic interaction.

Explore how verbal and non-verbal communication influence clinical decision-making.

Determine whether an educational intervention (workshop for physiotherapists) can achieve greater patient involvement in decision-making processes and improve: perceptions of empathy; enablement; communication; satisfaction; functional outcome; and number of face-to-face contacts.

Project team

Dr Lisa Roberts – Arthritis Research UK senior lecturer in physiotherapy / consultant physiotherapist (principal investigator)
Professor Paul Little , Professor of Primary Care Research
Professor Maria Stokes, Professor of Neuromuscular Rehabilitation
Professor Cyrus Cooper, Director MRC Life-course Epidemiology Unit
Dr Rose Wiles, Co-Director and Principal Research Fellow, ESRC National Centre for Research Methods
Mr Mark Mullee, Director, Research Design Centre
Dr Jennifer Cleland, Senior Clinical Lecturer, Lead for Medical Education Research and Clinical Communication, Division of Medical and Dental Education, University of Aberdeen

Collaborating with ESRC National Centre for Research Methods, MRC Epidemiology Resource Centre, University of Southampton and University of Aberdeen

Project funder

Arthritis Research UK: AHP Academic Post (Senior Lectureship) in Rheumatology


Associated research themes

Communication / interaction
Clinical decision-making
Back pain

Related research groups

Active Living and Rehabilitation

Conferences and events associated with this project:

2009: Wessex Medical Trust Student Innovation Grant: Piloting an analysis of verbal communication using Synote in consultations between physiotherapists and people with back pain.

2008: Keynote address: Red Flags in the Clinical Setting – Issues of Communication: Danish Society of Manual Therapy & Danish Association of McKenzie Physiotherapists, Korsør, Denmark.

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