title: Opening clinical encounters in an adult musculoskeletal setting.
abstract: Effective communication between healthcare professionals and their patients is crucial for successful consultations, and can profoundly affect patients' adherence to treatment. Despite this evidence, communication within the physiotherapy profession is still underexplored, in particular, how 'best' to open clinical encounters. This study explores the issue by seeking the preferences of physiotherapists for opening encounters in the adult musculoskeletal outpatient setting. Initially, 42 consultations and 17 first follow-up encounters were observed between qualified physiotherapists and patients with back pain. These encounters were audio-recorded, analysed and used to develop a questionnaire to determine clinicians' preferences for opening encounters. From these findings, a synopsis of the questionnaire was posted on the four most-relevant professional networks of the national, interactive Chartered Society of Physiotherapy (iCSP) website, to canvass opinion more widely. Among the 43 physiotherapists who responded, the preferred 'key clinical question' for an initial encounter was: "Do you want to just tell me a little bit about [your 'problem presentation'] first of all?"; and for follow-up encounters: 'How have you been since I last saw you?' These results provide an important and novel contribution to the profession, as debate on this issue has not previously been published. Although the sample size in this study is small, the aim of this paper is to generate reflection and debate among clinicians on their preferences for opening patient encounters and optimising the non-specific treatment effects.
authors.affiliation: Faculty of Health Sciences, Building 45, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, United Kingdom.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Chester
authors.affiliation: Faculty of Health Sciences, Building 45, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, United Kingdom.
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Robinson
authors.affiliation: Faculty of Health Sciences, Building 45, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, United Kingdom; Therapy Services Department, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, United Kingdom. Electronic address: L.C.Roberts@soton.ac.uk.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008487:Medical History Taking / Q000379:methods; D008875:Middle Aged; D010147:Pain Measurement; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D059825:Physical Therapists / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D058996:Quality Improvement; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Communication; History-taking; Interaction; Musculoskeletal; Physiotherapy