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Patients’ perceptions of post-treatment experiences in osteopathy: A qualitative study using focus groups
Bright, P. [8]
Rajendran, D. [16]
Bettles, S. [3]
Carnes, D. [22]
Mullinger, B. [13]

Journal: European Journal of Integrative Medicine Date: 2011/06, 3(2):Pages: e109. doi: Subito , type of study: qualitative study

Free full text   (https://www.sciencedirect.com/science/article/abs/pii/S1876382011000321)

Keywords:

adverse events [35]
patients perception [1]
osteopathic manipulative treatment [2973]
OMT [2951]
qualitative study [209]

Abstract:

Background: Mild-to-moderate adverse events are common following manual therapies [1]. In our pilot survey among osteopathic patients, many reported experiencing transient local pain (∼50%) and stiffness (∼40%); other reports included unexpected tiredness (∼25%) and headaches (∼10%)[2]. To help set this data in context, we need a greater understanding of how patients view these experiences; such insight will allow collection of patient-centred data, which will provide research evidence to inform undergraduate teaching, and help to enhance practitioner-patient communication. Methods Aim To gain understanding of osteopathic patients’ perceptions of post-treatment experiences and to determine what to them constitutes an ‘adverse event’. We used a phenomenological approach to explore osteopathic patients’ experiences using focus groups (FGs). We developed a topic guide based on findings from our previous survey, a literature review and brainstorming: it covered patients’ experiences of how they felt after osteopathic treatment; acceptability; impact on daily living; and what they consider to be ‘adverse’. The topic guide was piloted in a FG with volunteers who were users of osteopathic services; we used impartial language and avoided the term ‘adverse events’ to prevent influencing participants’ perceptions. Using purposive sampling we then identified patients who had recently received treatment at the European School of Osteopathy (ESO) and scheduled two FGs with mixed ages and genders. Eachwas recorded, and lasted for up to 90 min. We used a framework approach to analyse the data [3]; we identified themes and subthemes from the FG transcripts (which had been transcribed verbatim and were anonymised). Ethics approval was obtained from the ESO Ethics Committee. Results There were 19 participants (11 females) in the three FGs, aged between 19 and 66 years (mean age 46 years); all had received osteopathic treatment within the previous six months. Our initial framework contained four main themes (with 23 sub-themes): patient–practitioner encounter; environment; treatment after-effects; expectations of the osteopathic encounter. Adopting an iterative approach, we used these themes to deduce meaning from experiences and to develop a conceptual model to explain what influences a patient to perceive post-treatment effects as positive or negative. Preliminary findings suggest that patients’ perceptions are an integral part of their total osteopathic experience and may be at variance with what practitioners perceive as ‘adverse’. Discussion: The osteopathic patient’s perspective has not been explored previously in the context of adverse events [4]. Our findings will be valuable in education and clinical practice, thereby improving practitioner–patient communication and enhancing patient care.

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