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Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation

OBJECTIVES: A randomized controlled trial of a new type of Physiotherapy informed by Acceptance and Commitment Therapy (PACT), found that it improved functioning in people with chronic low back pain compared to usual physiotherapy care. Fidelity evaluation is necessary to understand trial processes...

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Autores principales: Galea Holmes, Melissa N., Wileman, Vari, Hassan, Shaira, Denning, Julie, Critchley, Duncan, Norton, Sam, McCracken, Lance M., Godfrey, Emma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540449/
https://www.ncbi.nlm.nih.gov/pubmed/35118763
http://dx.doi.org/10.1111/bjhp.12583
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author Galea Holmes, Melissa N.
Wileman, Vari
Hassan, Shaira
Denning, Julie
Critchley, Duncan
Norton, Sam
McCracken, Lance M.
Godfrey, Emma
author_facet Galea Holmes, Melissa N.
Wileman, Vari
Hassan, Shaira
Denning, Julie
Critchley, Duncan
Norton, Sam
McCracken, Lance M.
Godfrey, Emma
author_sort Galea Holmes, Melissa N.
collection PubMed
description OBJECTIVES: A randomized controlled trial of a new type of Physiotherapy informed by Acceptance and Commitment Therapy (PACT), found that it improved functioning in people with chronic low back pain compared to usual physiotherapy care. Fidelity evaluation is necessary to understand trial processes and outcomes. This study evaluated PACT treatment fidelity including delivery, receipt, and enactment. DESIGN: A mixed‐methods study nested within a randomized controlled trial was conducted. METHODS: A total of 72 (20% of total) PACT treatment audio files were independently assessed by two raters, according to a novel framework developed to measure PACT treatment content adherence, therapeutic alliance, ACT competence, and treatment enactment. Interview transcripts from 19 trial participants randomized to PACT were analysed thematically for evidence of treatment receipt and enactment. RESULTS: PACT physiotherapists delivered treatment as intended with high content adherence and satisfactory therapeutic alliance, but ACT competence was low. Qualitative findings indicated participant receipt of 11/17 and enactment of 3/17 components; 89% (n = 17) and 47% (n = 9) of participants reported treatment receipt and enactment of at least one component, respectively. CONCLUSIONS: This mixed‐methods study of PACT treatment demonstrated high fidelity reflecting treatment content delivery and receipt, and therapeutic alliance. There was some evidence of treatment enactment in participants with chronic low back pain. Low ACT competence could be addressed through additional support and adaptations to therapeutic processes for delivery by physiotherapists.
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spelling pubmed-95404492022-10-14 Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation Galea Holmes, Melissa N. Wileman, Vari Hassan, Shaira Denning, Julie Critchley, Duncan Norton, Sam McCracken, Lance M. Godfrey, Emma Br J Health Psychol Original Articles OBJECTIVES: A randomized controlled trial of a new type of Physiotherapy informed by Acceptance and Commitment Therapy (PACT), found that it improved functioning in people with chronic low back pain compared to usual physiotherapy care. Fidelity evaluation is necessary to understand trial processes and outcomes. This study evaluated PACT treatment fidelity including delivery, receipt, and enactment. DESIGN: A mixed‐methods study nested within a randomized controlled trial was conducted. METHODS: A total of 72 (20% of total) PACT treatment audio files were independently assessed by two raters, according to a novel framework developed to measure PACT treatment content adherence, therapeutic alliance, ACT competence, and treatment enactment. Interview transcripts from 19 trial participants randomized to PACT were analysed thematically for evidence of treatment receipt and enactment. RESULTS: PACT physiotherapists delivered treatment as intended with high content adherence and satisfactory therapeutic alliance, but ACT competence was low. Qualitative findings indicated participant receipt of 11/17 and enactment of 3/17 components; 89% (n = 17) and 47% (n = 9) of participants reported treatment receipt and enactment of at least one component, respectively. CONCLUSIONS: This mixed‐methods study of PACT treatment demonstrated high fidelity reflecting treatment content delivery and receipt, and therapeutic alliance. There was some evidence of treatment enactment in participants with chronic low back pain. Low ACT competence could be addressed through additional support and adaptations to therapeutic processes for delivery by physiotherapists. John Wiley and Sons Inc. 2022-02-03 2022-09 /pmc/articles/PMC9540449/ /pubmed/35118763 http://dx.doi.org/10.1111/bjhp.12583 Text en © 2022 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Galea Holmes, Melissa N.
Wileman, Vari
Hassan, Shaira
Denning, Julie
Critchley, Duncan
Norton, Sam
McCracken, Lance M.
Godfrey, Emma
Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title_full Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title_fullStr Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title_full_unstemmed Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title_short Physiotherapy informed by Acceptance and Commitment Therapy for chronic low back pain: A mixed‐methods treatment fidelity evaluation
title_sort physiotherapy informed by acceptance and commitment therapy for chronic low back pain: a mixed‐methods treatment fidelity evaluation
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540449/
https://www.ncbi.nlm.nih.gov/pubmed/35118763
http://dx.doi.org/10.1111/bjhp.12583
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