Does adherence to physiotherapy depend on the typologies of patients with non-specific low back pain and their physiotherapists? A typology study

Abstract

Abstract Background Patient adherence to physiotherapy is influenced by a multitude of factors including the personalities and attitudes of patients and physiotherapists. Personalities and attitudes can be assigned to various typologies. This study aims to identify different typologies of patients with back pain and their physiotherapists and attempts to explain how patient and physiotherapist typologies may influence patient adherence. Method This study was based on a secondary data analysis from focus group interviews to identify barriers and facilitators for adherence. Transcribed interview data were used for a structured content analysis based on categorization and coding. The Big-five Personality Traits were applied to build deductive categories about the physiotherapists and the patients. These were defined according to the locus of control, activity level, and adherence quality to physiotherapy. Transcribed interview data were coded and allocated to categories using structured content analysis. Results Ten patients with low back pain (6 women; mean age = 37.5 years) and 11 physiotherapists (5 women; mean age = 33 years) were recruited from different physiotherapy centers in Switzerland and Germany. Four types of patients and three of the physiotherapist types were identified based on responses to interview questions. The four types of patients are based on conscientiousness, high level of activity, internal locus of control, high level of adherence (= type 1); conscientiousness and neuroticism, high level of activity, internal locus of control, low level of adherence (= type 2); extraversion, low level of activity, external locus of control, high level of adherence (= type 3); agreeableness, combination of active and passive behavior, combination of internal and external locus of control, high level of adherence (= type 4). The three types of physiotherapists are based on conscientiousness, high adherence influence, use of guidelines (= type 1); agreeableness, acceptance of requests, low adherence influence (= type 2); neuroticism, high adherence influence, preference for active therapy (= type 3). Conclusion Awareness of the congruence of expectations, behavior, and treatment approaches may facilitate adherence and subsequently treatment effectiveness. Further research should aim to validate the association of typologies and adherence.