Clinical trial NCT03266796: Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study
Official title: Shared Decision Making in Physical Therapy: a Cross-sectional Observational Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Shared Decision Making
Lead sponsor: Klinik Valens
Sponsor class: OTHER
First posted: 2017-08-30
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Thirty patients will be recruited. The planned sample may seem heterogenic because patients with all musculoskeletal conditions are included. However, the goal setting process is expected to be independent of diagnosis and the sample is therefore considered sufficiently homogeneous.

Brief summary: Shared decision making (SDM) is increasingly recommended in health care and reduces the unbalanced power between physical therapists and patients. There is an increased focus on communication between physical therapists and their patients during the goal setting process in current research. This study will focus on SDM in physical therapy goal setting.

The SDM Process includes a problem definition and different goal options. Good communication between physical therapists and patients during the goal setting process with an explicit agreeing on both sides regarding treatment goals and options improves patient satisfaction, treatment adherence and health outcomes.

Patients generally prefer to be actively involved in the shared decision making process. However, the preferred level of involvement of patients regarding decisions differs. Therefore, physical therapist should consider about patients' preferred level of involvement in shared decision making. Previous research observed SDM behaviours of physical therapists only in private practice settings. Research in other settings like the rehabilitation setting are recommended. It is unknown whether there are differences between settings in the SDM behaviours of physical therapists during first consultation.

Detailed description: Background

Shared decision making (SDM) is increasingly recommended in health care and reduces the unbalanced power between physical therapists and patients. There is an increased focus on communication between physical therapists and their patients during the goal setting process in current research. This study will focus on SDM in physical therapy goal setting.

The SDM Process includes a problem definition and different goal options. Therefore, SDM may be especially important during the goal setting process in the first consultation, where a problem definition and several goal options are of interest.

An increased involvement of patients in SDM is based on clear information, empathy, two-way communication and respect for patients' beliefs and concerns. Therefore, patients are more willing to reveal information. Good communication between physical therapists and patients during the goal setting process with an explicit agreeing on both sides regarding treatment goals and options improves patient satisfaction, treatment adherence and health outcomes.

During the shared goal setting several topics should be discussed including patient's expectations and concerns, different possible goals and their pros and cons. The quality of this communication during the goal setting process can be evaluated by the OPTION Scale.

Patients generally prefer to be actively involved in the shared decision making process.

Previous research observed SDM behaviours of physical therapists, the patient's preferred level of involvement and the agreement between the patient's preferred level of involvement and the physical therapists' perception of the patient's preference during different therapy consultations in private practice settings.

Communication between physical therapists and patients may be affected by patient's self-efficacy and educational background and physical therapist's education and working experiences. These factors will therefore be evaluated in the planned study. In addition, therapists should consider patients individual preferences regarding their preferred level of involvement in the goal setting process. The control preference scale measures patients' preferred level of involvement and physical therapists' perception of this level.

It is unknown whether there are differences between settings in the SDM behaviours of physical therapists. SDM may be different in rehabilitation and private practice settings. As in private practice one physical therapist is treating the patient, there are several physical therapists treating the patient in rehabilitation setting.

Eligibility criteria: Inclusion Criteria:

musculoskeletal disorders First treatment German speaking

Exclusion Criteria:

n/a

Primary outcomes:
measure: OPTION scale
timeFrame: day 1 (e.g. "through study completion, an average of 1 year")
Secondary outcomes:
measure: Control Preference Scale (CPS)
timeFrame: day 1 (e.g. "through study completion, an average of 1 year")
Other outcomes:
measure: General Self-Efficacy Scale (GSE)
timeFrame: day 1 (e.g. "through study completion, an average of 1 year")
measure: Characteristics of patients and physical therapists
timeFrame: day 1 (e.g. "through study completion, an average of 1 year")
Locations:
city: Valens
country: Switzerland
facility: Kliniken Valens
Study officials:
affiliation: Klinik Valens
name: Andrea C. Hausheer, cand. MScPT
role: PRINCIPAL_INVESTIGATOR
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