Introduction: Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown. Methods: A multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A’) was used including a 3 month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep. Results: Nine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up. Conclusion: Our study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.
One challenge novice nurses face at the start of their career is coming to grips with the tumultuous working environment and its social dynamics. Assertive behavior and interprofessional communication play a key role in maintaining one’s health throughout this process: skills which novice nurses feel they lacked in their education. Within their education, clinical placements providea true-to-life working environment to train these skills. However, studies show that assertive behavior and interprofessional communication skills are not structurally addressed within this learning environment. To alleviate this theory-practice gap, our study focused on developing a digital tool together with nursing students that helps them structurally reflect upon and monitor these skills. Our main question was: How do students want to reflect upon their assertive behavior and interprofessional communication during their clinical placement using a digital tool?
In this thesis, a Dutch version of the Brief IPQ is presented to assess IPs in daily physiotherapy practice in The Netherlands. Further, a literature overview of the existing associations and prognosis of IPs on MSP and functioning is presented, and these associations in primary physiotherapy care in The Netherlands are explored. The impact of a matched care physiotherapy package, matched to dysfunctional IPs, and MSP and physical functioning is studied. In this thesis, three themes (ie. measurement, association / prediction and treatment) are explored for their contribution to physiotherapy management of MSP in general, and especially for low back pain
