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Implementation of a behavioral medicine approach in physiotherapy: impact and sustainability
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet; Sahlgrenska Academy.
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2019 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: To explore the effects on and sustainability of physiotherapists’ clinical behavior when using facilitation to support the implementation of a behavioral medicine approach in primary health care for patients with persistent musculoskeletal pain.

Methods: A quasi-experimental pre-/post-test trial was conducted. Fifteen physiotherapists were included in the experimental group, and nine in the control group. Based on social cognitive theory and the Promoting Action on Research Implementation in Health Services framework, facilitation with multifaceted implementation methods was used during a six-month period. Clinical behaviors were investigated with a study-specific questionnaire, structured observations, self-reports and patient records. Descriptive and non-parametric statistical methods were used for analyzing differences over time and effect size.

Results: A sustained increase in self-efficacy for applying the behavioral medicine approach was found. Clinical actions and verbal expressions changed significantly, and the effect size was large; however, changes were not sustained at follow-ups. The behavioral changes were mainly related to the goal setting, self-monitoring and functional behavioral analysis components. No changes in clinical behavior were found in the control group.

Conclusion: Tailored multifaceted facilitation can support the implementation of a behavioral medicine approach in physiotherapy in primary health care, but more comprehensive actions targeting sustainability are needed.Implications for rehabilitation Tailored multifaceted facilitation can support the implementation of an evidence based behavioral medicine approach in physiotherapy. Facilitation can be useful for increasing self-efficacy beliefs for using behavioral medicine approach in physiotherapist’s clinical practice. Further research is required to establish strategies that are effective in sustaining behavioral changes.

Place, publisher, year, edition, pages
2019.
Keywords [en]
clinical competence, evidence-based practice, musculoskeletal pain, physiotherapy, primary health care, self-efficacy
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-29978DOI: 10.1080/09638288.2019.1596170ISI: 000465891500001PubMedID: 30999779Scopus ID: 2-s2.0-85064690361OAI: oai:DiVA.org:du-29978DiVA, id: diva2:1313661
Available from: 2019-05-06 Created: 2019-05-06 Last updated: 2019-05-17Bibliographically approved

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