Background & Aims

Over the past few years, many clinical guidelines have highlighted the importance of providing patient-centred care that meets patients’ needs [1,2]. Despite these recommendations, most studies target the needs assessed by experts (e.g., clinicians, researchers, healthcare managers, etc.) [3]. Only a few studies have focused on patient-perceived needs, which are not always in line with needs assessed by experts [4]. Moreover, the needs of people living with chronic pain also depend on their individual condition, experiences, and life contexts. Therefore, to adequately respect and respond to patients’ needs within physiotherapy services, it is crucial to better understand their perceived needs. Hence, the aim of this study was to identify and map the perceived needs of people living with chronic pain towards physiotherapy services.

Methods

We conducted a scoping review that followed the six stages framework proposed by Arksey and O’Malley (2005) [5]. Assisted by two librarians, we developed a comprehensive search strategy to search four databases (Medline, Embase, CINHAL and APA PsycINFO), as well as the grey literature. We included all studies written in English or French that described the perceived needs of adults living with chronic pain towards physiotherapy, regardless of their methodology or publication date. We then performed an inductive thematic analysis [6] of the results and discussion sections of these studies to identify the perceived needs. Once the needs were identified, we used a deductive qualitative approach to map these perceived needs into the seven dimensions of the patient-centred healthcare delivery framework by Mühlbacher (2015) [7] which was developed to help better organize healthcare services around patients’ needs.

Results

Our scoping review included 96 studies. Most of the studies were published since 2014 (n=68) in Europe (n=62). They used a qualitative design (n=77) and included participants having musculoskeletal chronic pain (n=78). Various perceived needs were identified, such as the needs for an empathetic relationship; for a clear, adapted and supervised exercise program; and for being offered a personalized treatment plan. Our mapping of the identified needs into the patient-centred healthcare delivery framework showed that most needs were associated with the dimensions of interpersonal care, individualized healthcare and professional care, while needs associated with the dimensions of access coordination and continuity; services and facilities; and data and information, were less present.

Conclusions

The findings of this review demonstrate the extent, and vast diversity of the needs perceived by people living with chronic pain regarding physiotherapy services. They also underline the importance of looking beyond the technical and professional aspects of physiotherapy services (e.g., dimension of professional care), and to further consider the interpersonal (e.g., dimension of interpersonal care) and personalized aspects (e.g., dimensions of interpersonal care and individualized healthcare) as well.

References

[1] Lin, I., Wiles, L., Waller, R., et al. (2020). What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med, 54(2), 79-86. doi:10.1136/bjsports-2018-099878

[2] Health Canada. (2021). An action plan for pain in Canada. Retrieved from https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021-rapport/report-rapport-
2021-eng.pdf

[3] Kamenov, K., Mills, J. A., Chatterji, S., et al. (2019). Needs and unmet needs for rehabilitation services: a scoping review. Disability & Rehabilitation, 41(10), 1227-1237. doi:https://dx.doi.org/10.1080/09638288.2017.1422036

[4] Kersten, P., George, S., McLellan, L., et al. (2000). Disabled people and professionals differ in their perceptions of rehabilitation needs. Journal of Public Health, 22(3), 393-399.

[5] Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. doi:10.1080/1364557032000119616

[6] Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi:10.1191/1478088706qp063oa

[7] Mühlbacher, A. C., & Bethge, S. (2021). Patients preferences. In V. Amelung, V. Stein, N. Goodwin, R. Balicer, E. Nolte, & E. Suter (Eds.), Handbook integrated care (pp. 39-52): Springer.

Presenting Author

Jonathan Gervais-Hupé

Poster Authors

Jonathan Gervais-Hupé

MSc

Université de Montréal

Lead Author

Arthur Filleul

MSc

Université Grenoble Alpes, France

Lead Author

Kadija Perreault

PhD

Center for Interdisciplinary Research in Rehabilitation and Social Integration, Canada

Lead Author

Isabelle Gaboury

PhD

Department of family medicine and emergency medicine, University of Sherbrooke, Canada

Lead Author

Timothy Wideman

McGill University

Lead Author

Céline Charbonneau

Association québécoise de la douleur chronique, Canada

Lead Author

Fatiha Loukili

Association des personnes vivant avec de la douleur chronique, Canada

Lead Author

Romane Beauvais

MSc

School of rehabilitation, Faculty of medicine, Université de Montréal, Canada

Lead Author

Marc-Antoine Campeau

MSc

School of rehabilitation, Faculty of medicine, Université de Montréal, Canada

Lead Author

Gevrey Jacob

MSc

School of rehabilitation, Faculty of medicine, Université de Montréal, Canada

Lead Author

Noémie Lasnier

MSc

School of rehabilitation, Faculty of medicine, Université de Montréal, Canada

Lead Author

Anne Hudon

PhD

School of rehabilitation, Faculty of medicine, Université de Montréal, Canada

Lead Author

Topics

  • Treatment/Management: Interventional Therapies – Other