Page 181 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

as post-treatment. For future research, it would be useful to assess the IPs and their changes during physiotherapy treatment and to integrate the assessments into the treatment plan. Furthermore, we established that the IP dimension Personal Control acted as a moderator in our study. This means that, if a patient at the beginning of the physiotherapy treatment exhibited a dysfunctional Personal Control IP, it predicted a poorer result for the physiotherapy treatment. We recommend assessing patients’ Personal Control IPs at baseline, before the start of the physiotherapy treatment, and try to improve these by, for instance, building on self-efficacy.
Chapter 8
General conclusions:
Based on this thesis and looking at whether and how IPs affect the symptoms of MSP, we conclude:
• The Brief IPQ-DLV can be used, in combination with a personal interview, in primary
physiotherapy care to assess patients’ perceptions about their illness.
• Baseline IPs are not predictive for recovery outcomes at 3 months in the physiotherapeutic
management of MSP.
• The IPs Consequences, Personal Control, Identity, Concern and Emotional Response
significantly mediate the effect of physiotherapy management in patients with persistent
low back pain.
• The IP Personal Control significantly modifies the effect of physiotherapy management in
patients with persistent low back pain.
Recommendations for further research:
• Investigate potential improvements of the Brief IPQ-DLV with ‘thinking-aloud’ studies with people with MSP.
• Carry out additional matched-care intervention studies of changing dysfunctional IPs and the impact of this on pain intensity and physical functioning in people with MSP.
• Conduct research on larger groups to investigate more precisely the modifying and mediation effects of each individual IP on MSP management outcomes.
Recommendations for clinical practice:
• To this end, make use of the Brief IPQ-DLV, followed up by interview to qualitatively explore patients’ perceptions.
• Explore dysfunctional IP dimensions Consequences, Personal Control, Identity, Concern and Emotional Response during physiotherapy treatment, for their mediating effect.
• Explore the dysfunctional IP dimension Personal Control before physiotherapy treatment
for its moderating effect.
Summary
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A