title: Exploring physiotherapists' personality traits that may influence treatment outcome in patients with chronic diseases: a cohort study.
abstract: BACKGROUND
  During treatment of patients with Chronic Diseases (CD) the therapist-patient interaction is often intense, and the strategies used during treatment require physiotherapists to assume a coaching role. Uncovering therapist factors that explain inter-therapist variation might provide tools to improve treatment outcome and to train future therapists. The purpose of this study was to explore the so-called 'therapist-effect', by looking at the influence of intrinsic therapist factors, specifically personality traits, on treatment outcome in patients with CD.
  
  
  METHODS
  A cohort study was performed using data from the NIVEL Primary Care Database (NPCD) in 2011-2012 and an additional questionnaire. Patients with CD (n = 393) treated by Dutch physiotherapists working in outpatient practices (n = 39) were included. Patient and treatment outcome variables were extracted from NPCD. The course of complaint was measured using the Numeric Rating Scale. Therapist variables were measured using a questionnaire consisting of demographics and the Big Five traits: Extraversion, Neuroticism, Agreeableness, Conscientiousness and Openness to experiences. Data were analysed using multilevel linear regression.
  
  
  RESULTS
  Only Neuroticism was found to be significant (Neuroticism F = 0.71, P = 0.01; therapist gender F = 0.72, P = 0.03; life events F = -0.54, P = 0.09; patient gender F = -0.43, P = 0.10; patient age F = 0.01, P = 0.27). Subgroup analyses of 180 patients with Osteoarthritis and 30 therapists showed similar results.
  
  
  CONCLUSIONS
  There are indications that patients with CD who are treated by therapists who tend to be calmer, more relaxed, secure and resilient have a greater reduction in severity of complaints compared to patients treated by therapists who show less of these traits. Being a male therapist and having experienced life events influence outcome positively. However, more extensive research is needed to validate the current findings.
authors.affiliation: Physiotherapy Science, Program in Clinical Health Sciences & Department of Rehabilitation, Nursing Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. m.buining@gmail.com.|NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht, 3500 BN, The Netherlands. m.buining@gmail.com.
authors.forename: Elisah Margretha
authors.initials: EM
authors.lastname: Buining
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht, 3500 BN, The Netherlands.
authors.forename: Margit K
authors.initials: MK
authors.lastname: Kooijman
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, Utrecht, 3500 BN, The Netherlands.
authors.forename: Ilse C S
authors.initials: IC
authors.lastname: Swinkels
authors.affiliation: Physiotherapy Science, Program in Clinical Health Sciences & Department of Rehabilitation, Nursing Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.|Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.
authors.forename: Martijn F
authors.initials: MF
authors.lastname: Pisters
authors.affiliation: Department of Rehabilitation, Nursing Science & Sport, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, 3508 GA, The Netherlands.
authors.forename: Cindy
authors.initials: C
authors.lastname: Veenhof
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D059825:Physical Therapists / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome