Clinical reasoning and critical reflection in physiotherapists’ examinations of patients with low back pain in its early phase: a qualitative study from physiotherapists’ point of view
Engelsk titel: Clinical reasoning and critical reflection in physiotherapists’ examinations of patients with low back pain in its early phase: a qualitative study from physiotherapists’ point of view
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Författare:
Piirainen, Arja
;
Karvonen, Eira
;
Paatelma, Markku
;
Laitinen-Väänänen, Sirpa
Email: eira.karvonen@kolumbus.fi
Språk: Eng
Antal referenser: 61
Dokumenttyp:
Artikel
UI-nummer: 18020026
Sammanfattning
Aim: The aim of this study was to deepen the current understanding of physiotherapists’ decisionmaking
process and more specifically, to investigate their reflections on their clinical reasoning when
examining low back pain patients.
Method: Data were collected in interviews with six physiotherapists, were the stimulated recall method
was used. Interviews were audio-recorded and transcribed and then analysed by content analysis.
Results: Physiotherapists critically analysed and reflected their choices and decisions in clinical reasoning
with patient’s symptoms, onset of pain, clinical test choices and results. They stopped to consider
the adequacy of tests for drawing conclusions and their own manual skills as physiotherapists and also
the classification of LBP being used. At critical reflection levels, based on King and Kitchener, physiotherapists’
judgements were at levels four to seven.
Conclusions: The results showed that physiotherapists critically justified their clinical reasoning by systemically
using a hypothetico-deductive reasoning model and reflected on their decisions in all phases
of low back pain patient’s examination, from the history to the physiotherapy diagnosis and also on
the classification of non-specific low back pain.