Physiotherapist-delivered Stress Inoculation Training for acute whiplash-associated disorders: A qualitative study of perceptions and experiences. (December 2018)

• Record Type: Journal Article
• Authors: Kelly, Joan M.; Bunzli, Samantha; Ritchie, Carrie; Kenardy, Justin; Smeets, Rob; Sterling, Michele
• Is Part Of: Musculoskeletal science and practice. Volume 38(2018)
• Page Start: 30
• Page End: 36
• Publication Date: 2018-12
• Subjects: Whiplash associated disorders -- Physical therapists -- Psychologically informed practice -- Qualitative research; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2018.09.005
• Languages: English
• ISSNs: 2468-8630

Abstract

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. 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. Highlights: Physiotherapists support adding Stress Inoculation Training to usual whiplash management. Use of Stress Inoculation Training components appeared feasible in routine practice. Education on program principles is recommended during pre-professional training.