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  • Physiotherapist-delivered Stress Inoculation Training for acute whiplash-associated disorders: A qualitative study of perceptions and experiences

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    Author(s)
    Kelly, Joan M
    Bunzli, Samantha
    Ritchie, Carrie
    Kenardy, Justin
    Smeets, Rob
    Sterling, Michele
    Griffith University Author(s)
    Bunzli, Samantha
    Year published
    2018
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    Abstract
    Background: Formally trained and accredited physiotherapists delivered Stress Inoculation Training (SIT) integrated with guideline-based physiotherapy management to individuals with acute whiplash associated disorders (WAD) as part of a randomised controlled trial. The delivery of SIT by physiotherapists is new. Objectives: To investigate physiotherapists' perspectives on delivering SIT as part of the trial and in routine practice. Design: Qualitative descriptive. Method: Physiotherapists (n = 11) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. ...
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    Background: Formally trained and accredited physiotherapists delivered Stress Inoculation Training (SIT) integrated with guideline-based physiotherapy management to individuals with acute whiplash associated disorders (WAD) as part of a randomised controlled trial. The delivery of SIT by physiotherapists is new. Objectives: To investigate physiotherapists' perspectives on delivering SIT as part of the trial and in routine practice. Design: Qualitative descriptive. Method: Physiotherapists (n = 11) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Findings were triangulated against an audit of physiotherapists' adherence to the SIT protocol. Results: Three themes were identified: perceived value; capacity to deliver; and adaptation and implementation. Physiotherapists' saw value in SIT in that they perceived the program to have improved patient outcomes, enhanced their therapeutic alliance, and provided new skills to manage psychological contributors to WAD. Physiotherapists' capacity to deliver the program was facilitated through the development of confidence in their ability to deliver sessions, viewing SIT as falling within their current professional identity, and having confidence in their ability to manage mismatches in patients' expectations of care. All physiotherapists reported having used SIT to some extent in routine practice, by selectively delivering sessions and/or integrating the content with other management. Physiotherapists were able to deliver SIT as was intended (94.6% adherence). Conclusions: Physiotherapists' supported adding SIT to usual management of individuals with acute WAD. Education on SIT principles is recommended during pre-professional training to facilitate future implementation.
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    Journal Title
    Musculoskeletal Science and Practice
    Volume
    38
    DOI
    https://doi.org/10.1016/j.msksp.2018.09.005
    Copyright Statement
    © 2018 Musculoskeletal Science and Practice. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Clinical sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/382038
    Collection
    • Journal articles

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