Search

Background/Aims: In studies exploring the effectiveness of physical therapy treatment for painful musculoskeletal conditions, interventions appear to improve patient-reported outcomes. The interventions adopt different approaches, but there is a lack of agreement about which approach is most effective. Thus, research is needed to look at the potential influence of other variables present, such as common factors. Common factors are elements present across different treatments, which are necessary conditions for forming a therapeutic alliance and providing patient-centred care. While there is a positive relationship between common factors and patient outcomes noted in physical therapy, the mechanism through which these factors influence patient outcomes is less understood. The aim of this study was to explore participants' perceptions of the influence of common factors on physical therapy outcomes. Methods: Interviews were undertaken with seven individuals participating in physical therapy. The contextual model provided the framework to move beyond defining common factors to discussing how these elements contribute to the therapeutic changes seen in physical therapy. Results: Participants discussed how the therapeutic relationship is influenced by perceived trust and credibility, enhanced by goal setting, and individualised care. When these common factors are present, the potential for engaging in the work of physical therapy and enacting healthy behaviours and actions by patients were enhanced. Conclusions: By understanding common factors in physical therapy, a more complete view of the effects of interventions may be possible. Implications for practice: This study sheds light on the clinical impact of common factors in physical therapy, highlighting the pivotal role of therapeutic relationships built on trust, credibility, and individualized care. Recognizing and integrating these common factors into practice may enhance patient engagement and foster better therapeutic outcomes in musculoskeletal conditions. [ABSTRACT FROM AUTHOR]

Therapeutic alliance (TA) has been positively correlated to improvements in patient outcomes. This study examined the Working Alliance Inventory (WAI) relationship with changes in disability and pain intensity for patients receiving physical therapy (PT) treatment for acute and chronic musculoskeletal pain conditions. Fifty participants were dichotomized into success or failure by the minimal clinically important difference (MCID) on region-specific patient-reported outcome measures (PROM) and Numeric Pain Rating Scale (NPRS). Regression and correlation statistics examined the relationship between WAI with change scores and quantity of PT. Independent t-tests compared WAI scores across categorical variables. WAI scores were higher for those meeting MCIDs on PROM and NPRS compared to those who did not. WAI scores were significantly correlated with improvement on region-specific outcome measures and NPRS. Regression analysis found the patient rating of the TA to be a positive predictor for improvement on regions specific outcome measures and NPRS. Patients who rated the TA higher were more likely to meet the MCID for region-specific disability and pain intensity. Patient ratings of the TA were associated with improved change scores on pain rating and standardized outcome measures during a course of treatment for musculoskeletal pain conditions. Patients' early rating of the therapeutic alliance (TA) is associated with improvements seen on pain and functional outcomes. Physical therapists should assess the TA and use strategies to enhance the alliance to optimize patient's experiences with physical therapy. [ABSTRACT FROM AUTHOR]

This article sets out a conceptual framework for examining future building as an emotionally reflexive practice of intimacy and gendered agency. Emotionally reflexive future building is a relational activity, subject to gendering but open to queering. We illustrate this by drawing on cases taken from three qualitative studies that deal with the future building of women in relationships that do not conform to norms around having and rearing children. By referring to the future building of single mothers, women who are undecided about having children and women in non-cohabiting distance relationships we illustrate the significance of reflexively making sense of one's own and others' emotions in navigating gendered constraints and opportunities. Anger, despair, ambivalence, love, guilt and other emotions are key in how women with differing degrees of economic security imagine and try to create futures that queer gender. [ABSTRACT FROM AUTHOR]

Reflexive emotionalisation means increased thinking about and acting on emotional experiences in response to major changes to social life, such as those accompanying colonisation. This article explains and develops this novel concept, assessing its usefulness through an exploratory assessment of reflexive emotionalisation in the formation of Aotearoa New Zealand as a colonised settler state. It is argued that as cultures met and sought to coexist, emotions were vital. Focusing on reflexive emotionalisation in Aotearoa reveals how differences in feeling rules were navigated, sometimes in violent ways, as power shifted towards the colonisers. Feelings of belonging are important in that ongoing process of reflexive emotionalisation, the elucidation of which provides a new understanding of social change and settler state formation that avoids casting colonised peoples as passive objects of 'progress' brought by colonisers. [ABSTRACT FROM AUTHOR]