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Improving patient self-management for musculoskeletal conditions (ChesterRU18SF)


Project Description

Background: Physiotherapists (PTs) and Occupational Therapists (OTs) recognise the importance of and often report using a biopsychosocial (BPS) approach when managing people with musculoskeletal pain. This is supported by clinical guidelines, a plethora of postgraduate training courses and the literature. However, reports from studies using external observers suggest a predominantly biomedical approach.

Patient self-management in between appointments, particularly in the form of a home exercise or activity plan, is often a key ingredient of therapy interventions. However, patient adherence to self-management can be low and this is associated with a poorer outcome. Within the time constraints of therapy appointments, therapists can find it challenging to explore, identify and discuss the patient’s psychosocial and environmental factors that may be facilitators and barriers to self-management. Patient-therapist communication is likely to be a key ingredient in facilitating self-management.

Aim: This research aims to identify the key barriers, facilitators and ingredients to successfully performing a self-management programme from the patient’s perspective and to develop an intervention. The focus will be on patient’s presenting to physiotherapists and occupational therapists with upper limb musculoskeletal conditions. Objectives: (1) conduct a systematic literature review (2) design a research proposal and gain ethical approval, (3) carry out qualitative research to explore patient’s views and preferences, (4) develop an intervention (5) carry out a small study using qualitative and quantitative methods to assess feasibility.

Training Programme: This will include developing skills in quantitative and qualitative research methods, intervention development and evaluation. It will also include wider study skills such as academic writing, evidence synthesis, writing for publication.


or more information on the supervisor for this project, please go here: https://people.uea.ac.uk/en/persons/r-chester or https://people.uea.ac.uk/en/persons/w-hardeman

The type of programme: PHD

Project Start Date: 2018/19

Full-time or Part-time

Entry Requirements: This project is suitable for someone with a good first degree (at least 2:1) in a related topic area, such as a Health related subject

The standard minimum entry requirement is 2:1




Funding Notes

This PhD project is offered on a self-funding basis. It is open to applicants with funding or those applying to funding sources. Details of tuition fees can be found at View Website

References

i) Chester, R., Jerosch-Herold, C., Lewis, J., Shepstone, L. (2016) Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: a multicentre longitudinal cohort study. British Journal of Sports Medicine 0:1-8 doi:10.1136/bjsports-2016-096084

ii) Lamming, L.; Pears, S.; Mason, D.; Morton, K.; Bijker, M.; Sutton, S.; Hardeman, W.: on behalf of the VBI Programme Team (2017) What do we know about brief interventions for physical activity that
could be delivered in primary care consultations? A systematic review
of reviews. Preventative Medicine 99: 152-163 doi.org/10.1016/j.ypmed.2017.02.017

iii) Pears, S.; Morton, K.; Bijker, M.; Sutton, S.; Hardeman, W.; on behalf of the VBI Programme Team (2014) Development and feasibility study of very brief interventions for physical activity in primary care. BMC Public Health 15:333 doi: 10.1186/s12889-015-1703-8

iv) Frawley, H.C.; Dean, S.G.; Slade, S.C.; Hay-Smith, J.C. (2017) Is Pelvic-Floor Muscle Training a Physical Therapy or a Behavioral Therapy? A Call to Name and Report the Physical, Cognitive, and Behavioral Elements. Physical Therapy 97 (4): 425-437 DOI: https://doi.org/10.1093/ptj/pzx006

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