Motivating patients with shoulder and back pain to self-care: can a videotape of exercise support physiotherapy?

摘要

Objectives The National Health Service is developing an ethos of self-care. Patients are being encouraged to become proficient in helpingthemselves. This has long been a philosophy of the physiotherapy profession, where self-care between consultations has been an integral partof the treatment process through encouraging the uptake of self-care skills training. This study explored how patients with shoulder and backpain perceived videotaped exercises and instructions to support their routine physiotherapy, and how the videotape was used.Design A videotape, developed by physiotherapists for patients with musculoskeletal problems, of exercises to view at home was given topatients by their physiotherapists to support their routine physiotherapy consultations. A qualitative methodology was used to examine howpatients responded to being given a videotape of exercises and instructions between consultations. Data were collected through semi-structuredinterviews.Setting The study was based in 26 general practices that had access to practice-based physiotherapists in two primary care trusts in thenorth-west of England.Participants Thirty-three patients with shoulder and back pain who received a videotape of exercises and advice were interviewed.Results Three themes emerged from the data: finding space for exercise; remembering and doing exercises; and supporting thephysiotherapy-patient relationship. Patients discussed aspects of motivation, and described how a videotape of exercises might supportor inhibit the performance of exercises prescribed by physiotherapists. Patients identified a range of different ways in which they derivedsupport from the videotape.Conclusions The videotape supported patients with a variety of different needs as it enhanced their ability to complete exercises correctly.Videotapes (or DVDs) are useful for patients and could be adopted as a tool to support treatment.