title: A clinical reasoning model focused on clients' behaviour change with reference to physiotherapists: its multiphase development and validation.
abstract: OBJECTIVE
  A biopsychosocial approach and behaviour change strategies have long been proposed to serve as a basis for addressing current multifaceted health problems. This emphasis has implications for clinical reasoning of health professionals. This study's aim was to develop and validate a conceptual model to guide physiotherapists' clinical reasoning focused on clients' behaviour change.
  
  
  METHODS
  Phase 1 consisted of the exploration of existing research and the research team's experiences and knowledge. Phases 2a and 2b consisted of validation and refinement of the model based on input from physiotherapy students in two focus groups (n = 5 per group) and from experts in behavioural medicine (n = 9).
  
  
  RESULTS
  Phase 1 generated theoretical and evidence bases for the first version of a model. Phases 2a and 2b established the validity and value of the model. The final model described clinical reasoning focused on clients' behaviour change as a cognitive, reflective, collaborative and iterative process with multiple interrelated levels that included input from the client and physiotherapist, a functional behavioural analysis of the activity-related target behaviour and the selection of strategies for behaviour change.
  
  
  CONCLUSIONS
  This unique model, theory- and evidence-informed, has been developed to help physiotherapists to apply clinical reasoning systematically in the process of behaviour change with their clients.
authors.affiliation: Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University , Västerås , Sweden .
authors.forename: Maria
authors.initials: M
authors.lastname: Elvén
authors.forename: Jacek
authors.initials: J
authors.lastname: Hochwälder
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dean
authors.forename: Anne
authors.initials: A
authors.lastname: Söderlund
mesh_terms: D000465:Algorithms; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D008297:Male; D008960:Models, Psychological; D026761:Physical Therapy Specialty; D013850:Thinking
keywords: Behaviour change; biopsychosocial; clinical reasoning; physiotherapy