“Selling” chronic pain: physiotherapists’ lived experiences of communicating the diagnosis of chronic nonspecific lower back pain to their patients
Introduction: Chronic nonspecific lower back pain (CNSLBP) is a common musculoskeletal condition which can be a source of significant distress and disability for patients. Approaches to managing CNSLBP have been explored in healthcare literature, as has the importance of communication in physiotherapy practice. However, no previous studies have explored clinicians’ experiences of communicating their understanding of this diagnosis to their patients. Methods: A qualitative research design, using hermeneutic phenomenological methodology, was employed. Five participants were purposively recruited for the research and data collected via semi-structured interviews. Interpretative phenomenologica…
Transitioning from adolescence to adulthood for young people living with cerebral palsy : a meta-ethnography
Transitioning from adolescence to adulthood appears to be a challenging period for young people living with cerebral palsy. The aim of this review was to highlight the challenges that might be experienced during this period. A systematic search of the literature and meta-ethnographic review examined seven qualitative research papers providing a detailed synthesis in the form of three domains summarised as ‘meaningful preparation for transition’, ‘becoming empowered’, and, ‘overcoming vulnerability’. These inform a discussion which shows that adolescents living with cerebral palsy are not prepared adequately for adult life. Examination of the literature stimulates curiosity as to the nature …
‘I just want someone to rub some life into them!’ : the lived experience of impaired sensation in the feet related to multiple sclerosis
Background: Impaired sensation in the feet is a commonly reported symptom experienced by people with multiple sclerosis. Aim: To explore the lived experiences of people living with multiple sclerosis-related impaired sensation in their feet. Method: Five open, unstructured interviews were analysed using a descriptive phenomenological method developed by Amedeo Giorgi. Findings: The essential structure of the research phenomenon consists of six key constituents: sense of heightened awareness of body sensation; sense of changed relationship to the feet; sense of changed participation in daily life; sense of the self with multiple sclerosis; sense of the meaning of interaction with others; and…
Iäkkäiden ihmisten ja eläkeikäisten vapaaehtoistyöntekijöiden kokemuksia kanssakäymisestä vapaaehtoistyössä
Kotona asumista korostavan hoivapolitiikan seurauksena on paljon iäkkäitä henkilöitä, jotka eivät pääse ulos kodistaan ilman apua. Tutkimuksessa tarkastellaan huonokuntoisten iäkkäiden ihmisten ja eläkeikäisten vapaaehtoistyöntekijöiden kokemuksia keskinäisestä kanssakäymisestään vapaaehtoistyöhön perustuvalla toimintajaksolla. Vapaaehtoistyöntekijät auttoivat kodin ulkopuolisiin aktiviteetteihin yksin asuvia iäkkäitä ihmisiä, joilla oli liikkumiskyvyn ongelmia. Tutkimuksessa oli mukana viisi iäkkään ihmisen ja eläkeikäisen vapaaehtoistyöntekijän muodostamaa paria. Tutkimusaineisto koostui iäkkäiden (79–87-vuotiaiden) ihmisten ja vapaaehtoistyöntekijöiden (61–71-vuotiaiden) yksilöhaastattel…
Physiotherapists' lived experiences of decision making in therapeutic encounters with persons suffering from whiplash-associated disorder: A hermeneutic phenomenological study.
Conceptual discussions related to clinical reasoning and decision making have evolved over the years from biomedical to incorporating more holistic approach to reasoning. Empirical studies exploring clinical reasoning and decision making in physiotherapy practice have mostly focused on aspects of managing persons with low back pain, such as exercise prescription, education and communicating diagnosis. There is a paucity of studies exploring decision making in whiplash‐associated disorder (WAD); thus, the aim of this study was to explore the physiotherapists' lived experiences of decision making related to treating persons with WAD. A qualitative research design based on hermeneutic phenomen…
‘’It was the end of the world” : The lifeworld of elite male rugby union players living with injury : An interpretative phenomenological analysis
Background: Professional rugby is an aggressive sport. Consequently, injuries are an inevitable part of a rugby player’s career. It is therefore crucial for sports medicine professionals to understand the subjective experience of injured athletes in order to optimize their care. Objectives: The purpose of this study was to take a lifeworld perspective to explore how living with injury was meaningful to professional rugby players. Methods: A purposive sample of five participants were recruited and data collection undertaken via semi-structured interviews. Audio-recordings were transcribed verbatim and analyzed using interpretative phenomenological analysis methodology to develop the themes. …
Conceptions of healthcare professionals about rehabilitees’ participation in goal setting in an acute hospital : a phenomenographic study
Purpose: In acute care, effective goal-setting is an essential phase of a successful rehabilitation process. However, professionals’ knowledge and skills in rehabilitee-centered practice may not always match the ways of implementing goal-setting. This study aimed to describe the variation in how acute hospital professionals perceive and comprehend rehabilitee participation in rehabilitation goal-setting. Methods: Data were collected by interviewing 27 multidisciplinary rehabilitation team members in small groups shortly after rehabilitation goal-setting sessions. A qualitative research design based on phenomenography was implemented. Results: We identified four conceptions of rehabilitee pa…
The Experience of Living through the Transition from Adolescence to Adulthood for Young People with Cerebral Palsy
This study explored the lived experience of transition from adolescence to adulthood for young people with cerebral palsy to inform occupational therapy practitioners as to what might promote positive life opportunities. A phenomenological methodology was used with six participants, aged 18 to 25 years with cerebral palsy. The findings are presented in the form of hermeneutic stories and three themes: The storm of uncertainty; time, space and the body, Capsizing in a world of others and, Securing anchorage; being heard and understood. Recommendations include service integration across health, social care and education based on partnership and provision of coordinators. peerReviewed
Käsityksiä yhteistoimijuudesta varhaiskasvatuksen toimintaympäristössä
Kuntoutuksen ja kasvatuksen yhteistoiminnan on pitkään kuvattu olevan murrosvaiheessa, jossa yksilöasiantuntijuuteen perustuvista toimintamalleista pyritään kohti yhteistoimintaa ja lapsen arjessa tapahtuvaa kuntoutusta. Yhteistoimijuudella pyritään tuen oikea-aikaiseen tarjoamiseen lapselle siten, että siitä hyötyy koko varhaiskasvatusyhteisö. Tutkimustehtävänä oli kuvata ammattilaisten sekä lasten vanhempien käsityksiä yhteistoimijuudesta varhaiskasvatuksen yhteistoiminnassa. Aineisto kerättiin yksilöhaastatteluina (n = 10) osana kehittämishanketta varhaiskasvatusympäristössä, jossa oli pidempään toiminut yhteisöllinen puheterapeutti ja hankkeen ajan myös toimintaterapeutti. Aineisto ker…
Honouring the opening: Unfolding the rich ground between the philosophical thinking of Martin Heidegger and practice-based empirical work
The aim of this article is to bring philosophical thinking closer to practice-based empirical work. Using Martin Heidegger’s philosophy, it offers a bridge between these two worlds, attempting to provide philosophical depth to the findings of a hermeneutic phenomenological study. This process unfolded through the appearance of three intertwined, potential, meaningful modes of being in the lifeworld: space as a condition for being and being for worlding the world; temporal and spatial self-being, the existence of multiple selves in time and space; and suffering and thriving as modes of being. The article extends the dialogue and concludes with key reflections and insight for research practic…
Perceptions of learning and teaching human movement in physiotherapy : A systematic review and metasynthesis of qualitative studies
Purpose: Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. Methods: The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. Resul…
The Work of Hermeneutic Phenomenology
This paper is an illustration of the application of a hermeneutic phenomenological study. The theory of meaning and interpretation, drawing on philosophical hermeneutics and the work of Gadamer and Heidegger, and its alignment with phenomenological thought is presented. The paper explains and aims to make visible how key concerns in relation to the fusion of horizons, hermeneutic understanding, hermeneutic circle and hermeneutic phenomenological attitude were implemented. The purpose is to provide practical guidance and illustrate a fully worked up example of hermeneutic phenomenological work as research praxis. This present paper makes a case that hermeneutic phenomenological work is deta…
Living with disability in a COVID-19 world
Patients’ conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy
To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT). As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions. The analysis revealed four descriptive categories: “hung out to dry,” “stuck,” “making sense and taking control,” and “holistic approach to care and living,” tha…
Patients' conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy.
To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT).As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions.The analysis revealed four descriptive categories: "hung out to dry," "stuck," "making sense and taking control," and "holistic approach to care and living," that …