Interaction between patient and physiotherapist: a qualitative study reflecting the physiotherapist's perspective.
OBJECTIVE
The interaction between patient and physiotherapist (PT) is central in physiotherapeutic treatment. The purpose of this study was to investigate expert physiotherapists' perception of important factors influencing the quality of the interaction in physiotherapeutic treatment.


METHODS
Ten experienced PTs working in primary healthcare were interviewed twice, triangulating a sort of important events, an exemplar and a key informant interview. The data were transcribed, coded and analysed for main themes and categories according to the qualitative technique described by Shepard et al. (1993) and Merriam (1988).


RESULTS
Important factors in interaction could be divided into the 'Prerequisites dimension' and the 'Interaction dimension'. In the former, the most dominant theme was 'Internal prerequisites of the PT'. The most-cited category in this theme was 'Practical professional skills and patient experience'. In the latter, the themes 'Establishing contact', 'Ways of contact', 'Frames' and the 'Therapeutic process' emerged. Here, the most-cited categories were 'Establishing contact and confidence', having a 'Therapeutic role', 'Being sensitive and intuitive', 'Encountering', 'Listening' and 'Identification of patient resources'. These factors were seen as essential for promoting a positive patient outcome. Interaction skills were reinforced by reflection on patients' experiences.


CONCLUSIONS
Interaction skills of the expert PT were thought to enhance the resources of the patient and lead to a positive patient outcome. Within professional development more emphasis ought to be put on reinforcing the reflective process of the PT, for instance by the use of supervision by an experienced colleague.
Gyllensten
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Department of Physical Therapy, University of Lund, Sweden. Amanda.Lundvik-Gyllensten sjukgym.lu.se
Gard
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Salford
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Ekdahl
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D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011369:Professional-Patient Relations