Challenges of person-centered care in physiotherapy for chronic pain: A qualitative metasynthesis

Desafios do cuidado centrado na pessoa em dor crônica na fisioterapia: uma metassíntese qualitativa

Abstract

Introduction:   Person-centered care (PCC) has been recommended as a suitable model for treating people with chronic musculoskeletal pain (CMP), emphasizing the need to understand how this model has permeated clinical practice in physiotherapy.

Objective:   To investigate how physiotherapists understand and implement PCC in the management of CMP.

Methods:   This is a metasynthesis of qualitative studies (PROSPERO CRD 42021268243) involving physiotherapists considering PCC in the treatment of individuals with CMP. The Critical Appraisal Skills Program was employed for methodological evaluation of the included studies, and inductive thematic analysis was used for synthesis and result construction.

Results:   Elements of PCC are present in patient assessment, recognizing the importance of deep patient evaluation and establishing a strong therapeutic bond. However, divergent perspectives and conflicts regarding how to conduct therapeutic approaches were evident in the studies, indicating questions and uncertainties in balancing patient needs and preferences with adherence to clinical guidelines.

Conclusion:   Physiotherapists participating in the studies understand the principles of PCC as relevant to clinical practice and consistently utilize them in patient assessment and building rapport. However, uncertainties persist in implementing PCC principles in the management of CMP, highlighting the need for further research to better understand the disparities found in therapeutic approaches and enhance professionals' preparedness to administer PCC.

Keywords:
Musculoskeletal pain; Patient-centered care; Physiotherapists