Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS31
successfully validated to collect information on EBP (bra)
use, problems with EBP (bras) and musculoskeletal complaints.
Analysis: A descriptive analysis of the quantitative data.
Results: In the NPBG, 41.2% of the patients has musculoskeletal
neck complaints and 47.1% has shoulder
complaints, compared to respectively 18.8% and 12.10% in
the PBG. 85.5% of the PBG wears her EBP bra every day,
56.5% wears it between 5 and 12 hours a day. 52.1% of the
patients wears an EBP bra for aesthetical reasons. 64% of
the PBG experiences problems with the EBP bra. The most
common problem is sliding up of the bra (82.6%). 78.4% has
difficulties participating in sports activities with the bra and
37.7% of the PBG has difficulties finding a EBP bra that fits
perfectly. QOL and sexual functioning are significantly different
between the PBG and the SRG and between the NPBG
and the SRG.
Conclusions: The NPBG experiences significantly more
musculoskeletal complaints than the PBG and the SRG.
These results support the crucial role of wearing an optimal
EBP bra after mastectomy to prevent musculoskeletal
complications by restoring the surgically created loading
unbalance. The SRG has a significantly higher QOL
and sexual functioning than patients without a reconstruction.
Future research is necessary to demonstrate
the interaction between EBP bra wearing and musculoskeletal
disorders more in detail to prevent these
complaints.
Implications: Physical therapy after mastectomy should be
more focused on posture disturbances than arm-shoulder
morbidity alone. Since an optimal EBP bra could partially
prevent posture related complaints, it is important that the
physical therapist integrates this knowledge into the rehabilitation
program.
Keywords: Mastectomy; External breast prosthesis; Musculoskeletal
complaints
Funding acknowledgements: Grant: 4 year IWT (Innovation
for Science and Technology) Scholarship since
01/01/2010.
Ethics approval: The ethics committee of the Academic
Hospital of Brussels approved this work.
Research Report Poster Display
Number: RR-PO-202-9-Wed Wednesday 22 June 12:00
RAI: Exhibit Halls 2&3
‘WE GOT THE WHOLE STORY ALL AT ONCE’:
PHYSIOTHERAPISTS’ USE OF KEY QUESTIONS
WHEN MEETING PATIENTS WITH
LONG-STANDING PAIN
Afrell M.
Purpose: The aim of this study was to find out how
physiotherapists experienced the influence of systematically
prepared key questioning on their relation to, and understanding
of, patients with long-standing pain.
Relevance: Long-standing musculoskeletal pain has many
dimensions. Physiotherapy lacks a tested method of dialogue
with which physiotherapists and patients can together explore
pain in all its complexity.
Participants: A group of six physiotherapists with long experience
of pain rehabilitation were asked to participate in this
study. Three worked at pain and rehabilitation clinics and two
in primary care and one privately as a Feldenkrais teacher.
The physiotherapists came from three different counties and
worked at different work places.
Methods: We conducted a focus-group interview study. The
physiotherapists used systematically prepared key questioning
in their encounters with their patients. The patients should
have had musculoskeletal pain for more than three months.
Two periods of work with the questions followed by discussions
in which the physiotherapists shared their experience
in a joint focus group. Verbatim transcripts of the discussion
constitute the data of the study.
Analysis: We used a phenomenographic research approach.
This is a qualitative approach originally developed within
pedagogical research. The aim is to discern and describe
ways of experiencing. Paramount was how the physiotherapists
understood the meaning and consequences of using
the key questions. The analysis was carried out mainly in
accordance with seven steps of phenomenographic analysis.
Results: The responses to the key questions gave the physiotherapists
an insight into the patient as a person. The questions
started a process of change in the patient and changed the
physiotherapist’s relation to her or him. The patient also
expressed feelings and experience, and this also seemed to
encourage a change in chosen coping strategies. This new
content of interaction challenged the physiotherapist’s role,
thus raising questions about her professional mandate.
Conclusions: A set of key questions specially worked out
for the purpose can give support and structure to the physiotherapist’s
dialogue with the patient with long-standing pain.
The questions make the patient prepared to reflect together
with the physiotherapist on his/her aching body and what it is
like to live with it. The key questions have thus proved to be
effective and to make the dialogue about the body possible
they will therefore be tried in an intervention study.
Implications: The present study illuminates the importance
of an extension of the role of the physiotherapist. The challenge
that is implied in meeting the whole person also feelings
of sorrow and anger, can necessitate more training and professional
counselling.
Keywords: Long-standing musculoskeletal pain; Dialogue
method; Key questions
Funding acknowledgements: This study is supported by
FORSS, Health Research Council in south-east of Sweden
(project F2002-201).
Ethics approval: The regional ethical board in Linköping
judged that ethical approval was not necessary as the focus
was the physiotherapists’ experience.