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Can patients with low back pain be satisfied with less than expected?
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The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS43–eS65
OA069 Can patients with low back pain be satisfied with less than expected? W.L. Silvis 1 , S.E. Lakke 2,∗ , P. Stegeman 3 , B.L.G.N. Speijer 3 , P.C.A.J. Vroomen 4 , M.H. Coppes 3,5 , M.F. Reneman 3,6 , R. Soer 3,7 , Groningen Spine Study Group 1 Hanze
University of Applied Sciences, Groningen, Netherlands 2 Hanze University of Applied Sciences, Physical Therapy, Groningen, Netherlands 3 University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, Netherlands 4 University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, Netherlands 5 University of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, Netherlands 6 University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, Netherlands 7 Saxion University of Applied Sciences, Expertise Center of Health and Wellbeing, Enschede, Netherlands Relevance: To get insight into the effect of patient expectation on satisfaction of care might enhance patient’s wellbeing and might give implications of patient centred care to physical therapist. Purpose: There is a lack of evidence on determinants of treatment satisfaction in patients with chronic low back pain (CLBP). One of the determinants might be the patient’s objectified treatment success. The aim of this study is, firstly, to explore the validity of a measurement on expectation and, secondly, to analyze relationships between satisfaction with care and patient’s pre-defined expectation. Methods/analysis: A prospective cohort study within care as usual. At baseline, treatment expectation was measured with questions inspired by the Pain Disability Index (PDI): the PDI-expectancy (PDI-E). Treatment success was considered if disability at the end of therapy was lower than, or equal to pre-treatment expectation (PDI T1 ≤ PDI-E T0 ). First, an exploratory factor analysis was performed on the new questionnaire to identify relevant constructs and to analyse if the new questions reflect the construct of the PDI. Second, Binary logistic regression models were used to analyze how much variance of satisfaction with care was explained by treatment success, pain disability at baseline, gender, age, duration of complaints and pain intensity. Results: 609 patients were included. The factor structure of the PDI-E had optimal fit with a one factor structure, similar
to the PDI. Correlation between treatment success and satisfaction with care was low (χ2 = 0.13; p < 0.01). Treatment success had a low contribution to satisfaction with care. Of all participants, 51.4% were satisfied with care even though treatment was not successful. Discussion and conclusions: The internal consistency of the PDI-E is adequate. Pre-treatment expectation contributes uniquely but low to satisfaction with care. It is recommended to measure the patient-therapeutic relationship, longitudinal continuity, patient’s involvement in the treatment, the aim of care seeking, patient’s perception on the information and instruction in future research. Impact and implications: To improve patient’s satisfaction with care, we recommend physical therapists, during the diagnostic process, to guide patients with LBP in their decision making process by means of determining realistic treatment goals and expectation about the results of care. Funding acknowledgement: No funding. http://dx.doi.org/10.1016/j.physio.2016.10.375 OA070 An exploration of students’ views of parallel teaching in pre-registration physiotherapy education J. Milligan 1,∗ , K. Grafton 1 , J.A. Hammond 2 1 Leeds
Beckett University, Faculty of Health and Social Sciences, Leeds, United Kingdom 2 Kingston University and St George’s, University of London, Faculty of Health, Social Care and Education, London, United Kingdom Relevance: Within the United Kingdom (UK) physiotherapy pre-registration training is provided at both undergraduate and postgraduate level at seventeen universities. Whilst upholding the standards of proficiency the manner in which the curriculum is delivered varies from institute to institute. Two UK based universities have studied the impact of delivering elements of the pre-registration curriculum to both undergraduates and postgraduate students simultaneously. Termed ‘parallel teaching’ it is defined as’. . .any form of teaching that involves undergraduate and postgraduate students being located in the same class’. This is possible when the content-related learning outcomes are similar for the two different groups. Subsequent assessment for the differing cohorts follows the specific academic standard requirements as per Quality Assurance Agency guidance. Parallel teaching is under-researched. It is not known how students perceive this mode of learning. Purpose: The aim was to explore the perceived benefits and challenges to parallel teaching of mixed undergraduate and postgraduate pre-registration physiotherapy students in the same learning environments.
The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS43–eS65
OA069 Can patients with low back pain be satisfied with less than expected? W.L. Silvis 1 , S.E. Lakke 2,∗ , P. Stegeman 3 , B.L.G.N. Speijer 3 , P.C.A.J. Vroomen 4 , M.H. Coppes 3,5 , M.F. Reneman 3,6 , R. Soer 3,7 , Groningen Spine Study Group 1 Hanze
University of Applied Sciences, Groningen, Netherlands 2 Hanze University of Applied Sciences, Physical Therapy, Groningen, Netherlands 3 University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, Netherlands 4 University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, Netherlands 5 University of Groningen, University Medical Center Groningen, Department of Neurosurgery, Groningen, Netherlands 6 University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, Netherlands 7 Saxion University of Applied Sciences, Expertise Center of Health and Wellbeing, Enschede, Netherlands Relevance: To get insight into the effect of patient expectation on satisfaction of care might enhance patient’s wellbeing and might give implications of patient centred care to physical therapist. Purpose: There is a lack of evidence on determinants of treatment satisfaction in patients with chronic low back pain (CLBP). One of the determinants might be the patient’s objectified treatment success. The aim of this study is, firstly, to explore the validity of a measurement on expectation and, secondly, to analyze relationships between satisfaction with care and patient’s pre-defined expectation. Methods/analysis: A prospective cohort study within care as usual. At baseline, treatment expectation was measured with questions inspired by the Pain Disability Index (PDI): the PDI-expectancy (PDI-E). Treatment success was considered if disability at the end of therapy was lower than, or equal to pre-treatment expectation (PDI T1 ≤ PDI-E T0 ). First, an exploratory factor analysis was performed on the new questionnaire to identify relevant constructs and to analyse if the new questions reflect the construct of the PDI. Second, Binary logistic regression models were used to analyze how much variance of satisfaction with care was explained by treatment success, pain disability at baseline, gender, age, duration of complaints and pain intensity. Results: 609 patients were included. The factor structure of the PDI-E had optimal fit with a one factor structure, similar
to the PDI. Correlation between treatment success and satisfaction with care was low (χ2 = 0.13; p < 0.01). Treatment success had a low contribution to satisfaction with care. Of all participants, 51.4% were satisfied with care even though treatment was not successful. Discussion and conclusions: The internal consistency of the PDI-E is adequate. Pre-treatment expectation contributes uniquely but low to satisfaction with care. It is recommended to measure the patient-therapeutic relationship, longitudinal continuity, patient’s involvement in the treatment, the aim of care seeking, patient’s perception on the information and instruction in future research. Impact and implications: To improve patient’s satisfaction with care, we recommend physical therapists, during the diagnostic process, to guide patients with LBP in their decision making process by means of determining realistic treatment goals and expectation about the results of care. Funding acknowledgement: No funding. http://dx.doi.org/10.1016/j.physio.2016.10.375 OA070 An exploration of students’ views of parallel teaching in pre-registration physiotherapy education J. Milligan 1,∗ , K. Grafton 1 , J.A. Hammond 2 1 Leeds
Beckett University, Faculty of Health and Social Sciences, Leeds, United Kingdom 2 Kingston University and St George’s, University of London, Faculty of Health, Social Care and Education, London, United Kingdom Relevance: Within the United Kingdom (UK) physiotherapy pre-registration training is provided at both undergraduate and postgraduate level at seventeen universities. Whilst upholding the standards of proficiency the manner in which the curriculum is delivered varies from institute to institute. Two UK based universities have studied the impact of delivering elements of the pre-registration curriculum to both undergraduates and postgraduate students simultaneously. Termed ‘parallel teaching’ it is defined as’. . .any form of teaching that involves undergraduate and postgraduate students being located in the same class’. This is possible when the content-related learning outcomes are similar for the two different groups. Subsequent assessment for the differing cohorts follows the specific academic standard requirements as per Quality Assurance Agency guidance. Parallel teaching is under-researched. It is not known how students perceive this mode of learning. Purpose: The aim was to explore the perceived benefits and challenges to parallel teaching of mixed undergraduate and postgraduate pre-registration physiotherapy students in the same learning environments.