Social power dynamics and partnership in stroke physiotherapy treatment interactions/

Abstract

The Department of Health recommends that stroke patients should be encouraged to become ‘expert patients’ to work in ‘partnership’ with physiotherapists in the management of treatment. However, research suggests that this may be difficult to achieve because therapists and patients may have different agendas in treatment and this can hinder shared communication. Focus groups with stroke physiotherapists were conducted to explore these problems and these showed that social power factors in the institution were influencing the understandings and interactions of therapists and patients in some way. Six qualitative case studies of original research were conducted each comprising observation of a stroke physiotherapy treatment session and one follow-up interview each with the therapist and patient involved to examine how therapists and patients understood and used power in treatment interactions to achieve their own aims to clarify how this influenced partnership working. Within and cross-case thematic analysis using the ‘Framework’ method was carried out following a symbolic interactionist approach. Four ‘case studies’ from a previous related study were then subjected to secondary analysis using the same analytic framework. The results showed that the treatment sessions were structured by four interaction forms between the participants: ‘Negotiation of leadership’; ‘Treatment activities interactions’; ‘Communication interactions’; ‘Social interactions’. Patients used skill in social and communication interactions to negotiate ‘good-patient’ behaviour and information to delegate leadership to the therapists and to gain therapists;’ expert attention in pursuit of recovery. Patients’ choice of a compliance role contradicts the ‘expert patient’ model but shows that co-operative working with therapists in the spirit of partnership is possible. However, lack of communication about strategic plans could hinder partnership working and this should be addressed.

More information

Identifiers

Catalogue record

Export record

ASCII CitationAtomBibTeXData Cite XMLDublin CoreDublin CoreEP3 XMLEndNoteHTML CitationHTML CitationHTML ListJSONMETSMODSMPEG-21 DIDLOpenURL ContextObjectOpenURL ContextObject in SpanRDF+N-TriplesRDF+N3RDF+XMLRIOXX2 XMLReferReference ManagerSimple Metadata