Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial

Objective: To assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for chronic low back pain. Design: Cluster randomized controlled trial. Setting: Publicly funded physi...

Full description

Bibliographic Details
Main Authors: Lonsdale, C., Hall, A., Murray, A., Williams, G., McDonough, S., Ntoumanis, Nikos, Owen, K., Schwarzer, R., Parker, P., Kolt, G., Hurley, D.
Format: Journal Article
Published: W.B. Saunders Co. 2017
Online Access:http://hdl.handle.net/20.500.11937/54609
_version_ 1848759415619977216
author Lonsdale, C.
Hall, A.
Murray, A.
Williams, G.
McDonough, S.
Ntoumanis, Nikos
Owen, K.
Schwarzer, R.
Parker, P.
Kolt, G.
Hurley, D.
author_facet Lonsdale, C.
Hall, A.
Murray, A.
Williams, G.
McDonough, S.
Ntoumanis, Nikos
Owen, K.
Schwarzer, R.
Parker, P.
Kolt, G.
Hurley, D.
author_sort Lonsdale, C.
building Curtin Institutional Repository
collection Online Access
description Objective: To assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for chronic low back pain. Design: Cluster randomized controlled trial. Setting: Publicly funded physiotherapy clinics. Participants: A sample (N=308) of physiotherapists (n=53) and patients with chronic low back pain (n=255; 54% female patients; mean age, 45.3y). Interventions: Patients received publicly funded individual physiotherapy care. In the control arm, care was delivered by a physiotherapist who had completed a 1-hour workshop on evidence-based chronic low back pain management. Patients in the experimental arm received care from physiotherapists who had also completed 8 hours of communication skills training. Main Outcome Measures: (1) Patient-reported adherence to their physiotherapists' recommendations regarding home-based rehabilitation measured at 1, 4, 12, and 24 weeks after the initial treatment session. (2) Pain and pain-related function measured at baseline and at 4, 12, and 24 weeks. Results: A linear mixed model analysis revealed that the experimental arm patients' ratings of adherence were higher than those of controls (overall mean difference, .41; 95% confidence interval, .10-.72; d=.28; P=.01). Moderation analyses revealed that men, regardless of the intervention, showed improvements in pain-related function over time. Only women in the experimental arm showed functional improvements; female controls showed little change in function over time. The Communication Style and Exercise Compliance in Physiotherapy intervention did not influence patients' pain, regardless of their sex. Conclusions: Communication skills training for physiotherapists had short-term positive effects on patient adherence. This training may provide a motivational basis for behavior change and could be a useful component in complex interventions to promote adherence. Communication skills training may also improve some clinical outcomes for women, but not for men.
first_indexed 2025-11-14T09:59:31Z
format Journal Article
id curtin-20.500.11937-54609
institution Curtin University Malaysia
institution_category Local University
last_indexed 2025-11-14T09:59:31Z
publishDate 2017
publisher W.B. Saunders Co.
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-546092020-07-23T08:07:34Z Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial Lonsdale, C. Hall, A. Murray, A. Williams, G. McDonough, S. Ntoumanis, Nikos Owen, K. Schwarzer, R. Parker, P. Kolt, G. Hurley, D. Objective: To assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for chronic low back pain. Design: Cluster randomized controlled trial. Setting: Publicly funded physiotherapy clinics. Participants: A sample (N=308) of physiotherapists (n=53) and patients with chronic low back pain (n=255; 54% female patients; mean age, 45.3y). Interventions: Patients received publicly funded individual physiotherapy care. In the control arm, care was delivered by a physiotherapist who had completed a 1-hour workshop on evidence-based chronic low back pain management. Patients in the experimental arm received care from physiotherapists who had also completed 8 hours of communication skills training. Main Outcome Measures: (1) Patient-reported adherence to their physiotherapists' recommendations regarding home-based rehabilitation measured at 1, 4, 12, and 24 weeks after the initial treatment session. (2) Pain and pain-related function measured at baseline and at 4, 12, and 24 weeks. Results: A linear mixed model analysis revealed that the experimental arm patients' ratings of adherence were higher than those of controls (overall mean difference, .41; 95% confidence interval, .10-.72; d=.28; P=.01). Moderation analyses revealed that men, regardless of the intervention, showed improvements in pain-related function over time. Only women in the experimental arm showed functional improvements; female controls showed little change in function over time. The Communication Style and Exercise Compliance in Physiotherapy intervention did not influence patients' pain, regardless of their sex. Conclusions: Communication skills training for physiotherapists had short-term positive effects on patient adherence. This training may provide a motivational basis for behavior change and could be a useful component in complex interventions to promote adherence. Communication skills training may also improve some clinical outcomes for women, but not for men. 2017 Journal Article http://hdl.handle.net/20.500.11937/54609 10.1016/j.apmr.2017.02.025 W.B. Saunders Co. fulltext
spellingShingle Lonsdale, C.
Hall, A.
Murray, A.
Williams, G.
McDonough, S.
Ntoumanis, Nikos
Owen, K.
Schwarzer, R.
Parker, P.
Kolt, G.
Hurley, D.
Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title_full Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title_fullStr Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title_full_unstemmed Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title_short Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial
title_sort communication skills training for practitioners to increase patient adherence to home-based rehabilitation for chronic low back pain: results of a cluster randomized controlled trial
url http://hdl.handle.net/20.500.11937/54609