There is a lot of poor qualitative research out there. Recently I reviewed an article in which the authors had spent three years studying people's experiences of chronic pain. They didn't identify any particular philosophy guiding their analysis, they just interviewed seven people and, somehow, came up with three 'themes': that pain was unpleasant; that it was aversive (something to be avoided); and it disrupted their lives. This is a good example of bad qualitative research. And there is a simple test you can apply if ever you're in doubt. All you need to do is to ask whether the research tells you anything you didn't already know. This study took three years, but told us … [Read more...] about Patient work
One of the interesting aspects of the recent physiotherapy discussions on social media about the benefits of the biopsychosocial model is the almost complete lack of the 'social'. Those who advocate for the model seem comfortable with the idea that physiotherapy might be ready to embrace its psychological dimensions - although, often, the 'psychological' is lazily referred to as a singular entity - but little is said about the social dimensions of physiotherapy. Perhaps physiotherapists are not aware of the full scale of the social dimensions of practice? Many practitioners, for instance, still ignore the fact that the social determinants of health (poverty, education level, access to … [Read more...] about Physiotherapy’s biopsycho (but not so much) social approach to future healthcare
Some of the discussion following the release of the CSP's recent video A new vision for physiotherapy prompted some interesting thoughts about the constant tension we face if we are to anticipate the future for our profession (link). A couple of issues surfaced from the blogpost and the comments that followed that prompted me to think about the link between physiotherapy, politics and evidence-based practice: Firstly, in defence of the CSP, it cannot be easy being a professional body these days. Social media has opened up great opportunities for communication and sharing of ideas, but it has also made a critic of everyone. This is perhaps one of the most important and challenging … [Read more...] about Physiotherapy, politics and evidence
Physiotherapists don't generally think our profession is 'political.' We mostly work on people's bodies, in one-to-one sessions, and few of us use our social standing as respected, orthodox health professionals to campaign for community causes. There are no physiotherapy-specific models of population health, and subjects like primary health care and health promotion are only just beginning to appear in undergraduate curricula. So while physiotherapists are experts in the assessing and treating the body-as-machine, and we are increasingly interested in people lived experiences of health and illness, we are less aware of the social determinants of health. Social determinants are those … [Read more...] about Social determinants of health – are we doing enough?
I start a week of teaching on the social determinants of health on Monday with our 1st year physiotherapy students. It's part of a course/module we run at AUT called 'Physiotherapy and Health Priorities' and it looks at applying public health principles to our practice. Social determinants aren't something that physios have spent a lot of time studying in the past, and it's a bit alarming to see how little research is out there that points to a role for the profession. We're not even driving the ambulance at the bottom of the cliff on this issue: we're the people who pick up the patients who have left the ambulance after its already crashed. Clearly this is not a wise or enviable … [Read more...] about Social determinants of health and physiotherapy