International Journal for Quality in Health Care 11:155-162 (1999)
© 1999 International Society for Quality in Health Care
Differences in stakeholder expectations in the outcome of physiotherapy management of acute low back pain
Centre for Physiotherapy Research, University of South Australia Adelaide, Australia
Correspondence to: Dr K Grimmer, Centre for Physiotherapy Research, University of South Australia, City East Campus, North Terrace, Adelaide, Australia 5000
e-mail: karen.grimmer@unisa.edu.au
Objective. To compare stakeholder expectations of outcome of physiotherapy management of acute low back pain.
Design. Observational design using interviews and questionnaires.
Setting. Practice/workplace.
Study participants. The study sample was from South Australia. It comprised 74 physiotherapists randomly selected from professional association listings (49.3% response rate), 121 physiotherapy patients (recruited by participating physiotherapists when attending their first physiotherapy treatment for acute low back pain), 21 general practitioners randomly selected from medical practitioner listings in the metropolitan telephone book (36.2% response rate) and 13 third party payers of a total of 16 available insurers in the metropolitan area (82% response rate).
Main outcome measurements. Stakeholders reported expectations of outcome at the end of the first treatment session and at the completion of the episode of care.
Results. There were differences in expectations between stakeholders, as well as between naive and experienced patients. Overall, patients expected symptom relief at the end of the first treatment. Naive patients decided to return for further treatment based on the relationship established with the therapist, whereas experienced patients also expected some advice on their condition during the first contact. Physiotherapists and referrers expected symptom relief and then long-term management strategies to be provided, and third party payers expected cost-efficient management of the condition and patient satisfaction.
Conclusion. Physiotherapists need to address potential imbalance of consumer knowledge and foster a quality partnership with their patients on the first visit to physiotherapy. Patients who are in pain may not derive full value from information provided in an untimely manner.
Keywords:low back pain, outcome, physiotherapy, stakeholders
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