@article{21698,
  author = {Murray A. and Hall A. and Hernon M. and Lonsdale C. and Hurley D. and Matthews J. and Jackson B. and Taylor I. and Toner J. and Guerin S.},
  title = {A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: face validity and feasibility of implementation},
  abstract = {<p>
BACKGROUND: Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient's motivation and maintenance of self-management behaviours can be positively influenced by the clinician's use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice. METHODS: A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. RESULTS: Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for refinement prior to scaling up for a definitive trial. CONCLUSION: The development process utilised in this study ensured the intervention was theory-informed and evidence-based, with recipients signalling its relevance and benefit to their clinical practice. Future research should consider additional intervention strategies to address barriers of social support and those beyond the clinician level.
</p>
},
  year = {2015},
  journal = {BMC Health Services Research},
  volume = {15},
  edition = {2015/07/06},
  pages = {260},
  isbn = {1472-6963 (Electronic)<br/>1472-6963 (Linking)},
  note = {Matthews, James<br/>Hall, Amanda M<br/>Hernon, Marian<br/>Murray, Aileen<br/>Jackson, Ben<br/>Taylor, Ian<br/>Toner, John<br/>Guerin, Suzanne<br/>Lonsdale, Chris<br/>Hurley, Deirdre A<br/>Research Support, Non-U.S. Gov't<br/>England<br/>BMC Health Serv Res. 2015 Jul 5;15:260. doi: 10.1186/s12913-015-0921-1.},
  language = {eng},
}