Communication during goal-setting in physiotherapy treatment sessions
Communication during goal-setting in physiotherapy treatment sessions
复制标题
DOI：
10.1191/0269215504cr745oa
复制
发表时间：
2004-09-01
影响因子：
3
通讯作者：
Parry, RH
中科院分区：
文献类型：
--
作者：
Parry, RH
目的：详细分析脑卒中康复机构物理治疗目标设定过程中治疗师与患者的沟通实践。为观察到的实践推断出解释。为了有助于理解的沟通带来的挑战，在goal-setting.Design：一个会话分析研究的视频记录的治疗sessions.Setting：物理治疗'健身房'在四个英国hospitals.Subjects：74个记录的会议涉及21名患者（52-86岁，11名女性）和10名高级物理治疗师。患者的残疾各不相同;没有严重的失语症。九名治疗师是女性，资格后的经验范围从3到23 years.Findings：八个目标设定事件被确定。除了一个之外，所有的治疗师都提供了目标问题或能力，随后为这些问题或能力设定了目标。在这种情况下，病人被要求提出问题之前，目标设定的详细审查。在征求病人的意见和将其纳入商定的目标方面都出现了各种各样的干扰困难和延误。治疗师处理困难的策略包括重复和限制性的问题，谈判，修改提出的goals.Conclusions：这个小，详细的研究结果可能有助于解释以前的观察罕见的目标设定和失败，以最大限度地提高患者的参与其中。目标设定，特别是在患者的意见被引出和纳入，涉及技能和努力，并受到强大的社会约束。发展对实践和限制因素的详细了解可能有助于改进专业实践、指导和教育。本文论证了使用会话分析方法对康复沟通进行详细分析的实用性。
Objective: To analyse in detail therapists' and patients' communication practices during physiotherapy goal-setting in stroke rehabilitation settings. To deduce explanations for observed practices. To contribute to understanding of the communication challenges entailed in goal-setting.Design: A conversation analytic study of video-recorded treatment sessions.Setting: Physiotherapy 'gyms' in four UK hospitals.Subjects: The 74 recorded sessions involved 21 patients (52-86 years, 11 female) and 10 senior physiotherapists. Patients' disabilities varied; none were severely aphasic. Nine of the therapists were female, postqualification experience ranged from 3 to 23 years.Findings: Eight goal-setting episodes were identified. In all but one, therapists supplied the target problems or abilities for which goals were subsequently set. The case in which the patient was asked to propose problems prior to goal-setting is examined in detail. Various interactional difficulties and delays arose both in eliciting the patient's views and incorporating them into agreed goals. Strategies by which the therapist dealt with difficulties included repeated and constraining questions, negotiation, and amending proposed goals.Conclusions: Findings of this small, detailed study might help explain previous observations of infrequent goal-setting and failure to maximize patients' involvement therein. Goal-setting, particularly where patients' views are elicited and incorporated, involves skill and effort, and is influenced by powerful social constraints. Developing detailed knowledge of both practices and constraints may contribute to improving professional practice, guidance and education. The paper demonstrates the utility of detailed analysis of rehabilitation communication using conversation analytic methods.