Training Physical Therapists in Person-Centered Practice for People With Osteoarthritis: A Qualitative Case Study.

Abstract

To explore physical therapists' experiences with, and the impacts of, a training program in person-centered practice to support exercise adherence in people with knee osteoarthritis. This was a qualitative case study using semi-structured interviews, nested within a clinical trial. Eight Australian physical therapists were interviewed before, and after, training in person-centered practice for people with knee osteoarthritis. Training involved a 2-day workshop, skills practice, and audit of 8 consultations with 4 patients (per therapist), and a final single-day workshop for audit feedback and consolidation. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were thematically analyzed. Three pretraining themes arose regarding usual communication style, definitions of person-centered care, and sharing exercise adherence responsibility. Three themes related to the training experience emerged: learning a new language, challenging conceptions of practice, and putting it into practice. Post-training, 3 themes arose regarding new knowledge deepening understanding of person-centered care, changing beliefs about sharing responsibilities, and changed conceptions of role. Although physical therapists found training overwhelming initially as they realized the limitations of their current knowledge and clinical practice, they felt more confident and able to provide person-centered care to people with knee osteoarthritis by the end of training. Training in structured person-centered methodology that provides opportunity for skills practice with patients using a restructured consultation framework can change physical therapists' beliefs about their roles when managing patients with osteoarthritis and positively impact their clinical practice.