Exploring the role of therapeutic alliance and biobehavioural synchrony in musculoskeletal care: Insights from a qualitative study.

Active inference Enactivism Manual therapy Musculoskeletal care Predictive processing Therapeutic alliance

Journal

Musculoskeletal science & practice
ISSN: 2468-7812
Titre abrégé: Musculoskelet Sci Pract
Pays: Netherlands
ID NLM: 101692753

Informations de publication

Date de publication:
14 Aug 2024
Historique:
received: 19 06 2024
revised: 06 08 2024
accepted: 09 08 2024
medline: 17 8 2024
pubmed: 17 8 2024
entrez: 16 8 2024
Statut: aheadofprint

Résumé

Person-centred care underscores the therapeutic alliance (TA) as fundamental, fostering positive treatment outcomes through collaborative patient-clinician interactions. Biobehavioural synchrony within the TA, essential for effective care, reflects an adaptive process where organisms align responses during interactions. Enactivism and active inference provide profound insights into human perception, reshaping musculoskeletal care understanding. Touch and verbal communication, integral to the TA, foster synchrony and alignment of personal beliefs. This study aimed to identify the tools used by manual therapists in musculoskeletal care to establish a TA with patients. Furthermore, it endeavours to evaluate the alignment of these strategies with current literature and their correlation with biobehavioural synchrony, enactivism, and the role of touch in active inference. The methodology followed rigorous qualitative research principles, particularly Grounded Theory and interpretative-constructivist principles, conducting eleven semi-structured interviews with open-ended questions. The core category identified in the study is elucidated as follows: "Interwoven Connection: The Fabric of Therapeutic Synchrony." The interviews unveiled three main categories, each comprising sub-categories: (1) Creating a meaningful dialogue; (2) Promoting active patient participation; (3) Synchronisation. Fostering meaningful dialogue, patient involvement, and therapeutic synchrony is crucial for a robust therapeutic alliance in musculoskeletal care. This underscores the importance of establishing a deep connection between clinicians and patients, central to effective person-centred care. Clinicians must prioritise two-way communication, empathy, and patient collaboration in defining personalised goals. Emphasizing touch and seeking patient feedback are also pivotal. Further research is needed to explore these elements and their impact.

Sections du résumé

BACKGROUND BACKGROUND
Person-centred care underscores the therapeutic alliance (TA) as fundamental, fostering positive treatment outcomes through collaborative patient-clinician interactions. Biobehavioural synchrony within the TA, essential for effective care, reflects an adaptive process where organisms align responses during interactions. Enactivism and active inference provide profound insights into human perception, reshaping musculoskeletal care understanding. Touch and verbal communication, integral to the TA, foster synchrony and alignment of personal beliefs.
AIM OBJECTIVE
This study aimed to identify the tools used by manual therapists in musculoskeletal care to establish a TA with patients. Furthermore, it endeavours to evaluate the alignment of these strategies with current literature and their correlation with biobehavioural synchrony, enactivism, and the role of touch in active inference.
METHODS METHODS
The methodology followed rigorous qualitative research principles, particularly Grounded Theory and interpretative-constructivist principles, conducting eleven semi-structured interviews with open-ended questions.
RESULTS RESULTS
The core category identified in the study is elucidated as follows: "Interwoven Connection: The Fabric of Therapeutic Synchrony." The interviews unveiled three main categories, each comprising sub-categories: (1) Creating a meaningful dialogue; (2) Promoting active patient participation; (3) Synchronisation.
CONCLUSION CONCLUSIONS
Fostering meaningful dialogue, patient involvement, and therapeutic synchrony is crucial for a robust therapeutic alliance in musculoskeletal care. This underscores the importance of establishing a deep connection between clinicians and patients, central to effective person-centred care. Clinicians must prioritise two-way communication, empathy, and patient collaboration in defining personalised goals. Emphasizing touch and seeking patient feedback are also pivotal. Further research is needed to explore these elements and their impact.

Identifiants

pubmed: 39151365
pii: S2468-7812(24)00259-5
doi: 10.1016/j.msksp.2024.103164
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103164

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Auteurs

Aurora Arrigoni (A)

Malta ICOM Educational, Santa Venera, Malta. Electronic address: aurora.arrigoni@studenti.icomedicine.com.

Giacomo Rossettini (G)

School of Physiotherapy, University of Verona, Via Bengasi 4, 37134, Verona, Italy; Department of Physiotherapy, Faculty of Sport Sciences, Musculoskeletal Pain and Motor Control Research Group, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain. Electronic address: giacomo.rossettini@univr.it.

Alvisa Palese (A)

Department of Medicine, University of Udine, Udine, Italy. Electronic address: alvisa.palese@uniud.it.

Mick Thacker (M)

Department of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: michaelthacker@rcsi.com.

Jorge E Esteves (JE)

Malta ICOM Educational, Santa Venera, Malta; UCO School of Osteopathy, Health Sciences University, London, UK; Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy. Electronic address: jorge.esteves@icomedicine.com.

Classifications MeSH