Does adherence to physiotherapy depend on the typologies of patients with back pain and their physiotherapists? A qualitative typology study.

BACKGROUND

Patient adherence to physiotherapy is influenced by a multitude of factors including the characteristics and attitudes of patients and physiotherapists. This study aims to identify typologies of patients with back pain and their physiotherapists and attempts to explain how typologies could 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 deductive and inductive categorization and coding. The Big-five Personality Traits were applied to build deductive categories about the physiotherapists' and the patients' typologies.

RESULTS

Ten patients with low back pain (6 women) and 11 physiotherapists (5 women) were recruited. The four patient types are based on conscientiousness, high activity level (HAL), internal locus of control (ILC), high adherence level (HADL) (= type 1); neuroticism, HAL, ILC, low adherence level (LADL) (= type 2); extraversion, HADL, external locus of control (ELC), HADL (= type 3); agreeableness, active behavior, ELC, HADL (= type 4). The three physiotherapist types are based on conscientiousness, high adherence influence (HADI), use of guidelines (= type 1); agreeableness, acceptance of requests, low adherence influence (= type 2); neuroticism, HADI, preference for active therapy (= type 3).

CONCLUSION

Awareness of typologies of patients with back pain and their physiotherapists may help to facilitate adherence and subsequently treatment effectiveness. Further quantitative research should aim to validate the correlation between the identified typologies and the adherence level of patients with back pain.