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Review: patients are “highly satisfied” with physical therapy

PainSci » bibliography » Hush et al 2010
Tags: treatment, scientific medicine, mind, structuralism, physical therapy, biomechanical vulnerability, manual therapy

Four pages on PainSci cite Hush 2010: 1. Reviews of Pain Professions2. Your Back Is Not Out of Alignment3. Pseudo-Quackery in Physical Therapy4. Placebo Power Hype

PainSci commentary on Hush 2010: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

Quite a bit of research has been done on physiotherapy and its efficacy, most of it quite discouraging. But what about the patients? Do they like it? Does it work well for them? This study attempted to calculate what the patient satisfaction level was for those who received physical therapy care.

A review of the literature was undertaken from several databases. A search of 3,790 studies allowed for a thorough study of 15 that met the criteria.

The researchers concluded that “patients are highly satisfied with musculoskeletal physical therapy care” and found that “the interpersonal attributes of the therapist and the process of care are key determinants of patient satisfaction.” Given that, it’s a bit odd that the authors thought it was “unexpected” that how well treatment worked was “infrequently and inconsistently associated with patient satisfaction.”

I’ve always considered it a given that how a patient feels about a treatment has almost nothing to do with how well it worked (independently of placebo), but this study is the first time I’ve seen some good hard evidence of it. “Satisfaction is not the same thing as effectiveness” (Long).

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Patient satisfaction is an important patient-centered health outcome. To date, no systematic review of the literature on patient satisfaction with musculoskeletal physical therapy care has been conducted.

PURPOSE: The purpose of this study was to systematically and critically review the literature to determine the degree of patient satisfaction with musculoskeletal physical therapy care and factors associated with satisfaction.

DATA SOURCES: The databases CINAHL, MEDLINE, and EBM Reviews were searched from inception to September 2009. Study Selection Articles were included if the design was a clinical trial, observational study, survey, or qualitative study; patient satisfaction was evaluated; and the study related to the delivery of musculoskeletal physical therapy services conducted in an outpatient setting. The search located 3,790 citations. Fifteen studies met the inclusion criteria.

DATA EXTRACTION: Two authors extracted patient satisfaction data and details of each study.

DATA SYNTHESIS: A meta-analysis of patient satisfaction data from 7 studies was conducted. The pooled estimate of patient satisfaction was 4.44 (95\% confidence interval=4.41-4.46) on a scale of 1 to 5, where 5 indicates high satisfaction and 1 indicates high dissatisfaction. Additional data were summarized in tables and critically appraised. Limitations Nonrespondent bias from individual studies may affect the accuracy and representativeness of these data.

CONCLUSION: Patients are highly satisfied with musculoskeletal physical therapy care delivered across outpatient settings in northern Europe, North America, the United Kingdom, and Ireland. The interpersonal attributes of the therapist and the process of care are key determinants of patient satisfaction. An unexpected finding was that treatment outcome was infrequently and inconsistently associated with patient satisfaction. Physical therapists can enhance the quality of patient-centered care by understanding and optimizing these determinants of patient satisfaction.

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:

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