The Meaning of Caring from the Perspectives of Patients Undergoing Physical Therapy: A Pilot Study
Greenfield, Bruce, Keough, Erin, Linn, Sydney, Little, Derek, Portela, Christine, Journal of Allied Health
This research note describes a pilot study that examined the meaning of caring from the perspectives of patients undergoing physical therapy. METHODS: A phenomenological methodology was used to explore the essential meaning of caring behaviors from the experiences of patients undergoing physical therapy. Patients were asked to describe caring interactions they have experienced with their physical therapists. RESULTS: The responses of the participants were inductively analyzed for themes and sub-themes that explained physical therapy caring. Based on that analysis, a central theme of mindful caring emerged from participants' responses. The theme of mindful caring reflected the physical therapist and patient relationship. Further analysis uncovered four sub-themes that gave a clearer picture of caring behaviors experienced by the participants. These included personal values, patient empowerment, open communication and exceptional service. CONCLUSION: The results of this pilot study demonstrate the dimensions of caring in healthcare practice from the unique perspectives of patients. J Allied Health 2010; 39:e43- e47.
ALLIED HEALTH PROFESSIONALS cultivate relationships that are guided by the value of caring. Caring has been identified in many healthcare professions as a core value of their professional ethos.1-13 Contemporary healthcare disablement models such as the International Classification of Impairment, Function and Disability (ICF),14 emphasize patient-centered caring to uncover and integrate patients' personal values into decisions about clinical care. The nature of caring in clinical practice is based on psychosocial literature,15,16 professional education literature,17-20 normative ethical theory,21 feminist ethics,22,23 and qualitative exploration.8,12,13,24-34 Most of that data about caring, in turn, are based on the experiences and the perspectives of ethicists, educators, and clinicians and little from the perspectives of patients.
Caring has been described in healthcare literature through several different and conflicting frameworks, including: virtue of caring8,35, ethics of caring6,20,36,37, novice and expert caring24,31,34,38, and rules based caring39,40 (Table 1 provides a summary of caring frameworks) An American Physical Therapy Association (APTA) consensus panel developed a document, Professionalism in Physical Therapy, to assist the profession in its transition to a doctoring profession. This document listed several core values of professionalism including caring. The consensus panel defined caring as concern, empathy, and consideration for the needs and values of others.41 The document lists sample indicators of caring behaviors including:
(1) understanding an individual's perspective,
(2) being an advocate for patient's/client's needs,
(3) empowering patients/clients to achieve the highest level of function possible and to exercise self-determination in their care, and
(4) embracing the patient's/client's emotional and psychological aspects of care.
Because caring is considered a core value of clinical practice, researchers in healthcare continue to explore caring behaviors from multiple perspectives. The purpose of this study was to explore the nature of caring from the perspectives of patients undergoing physical therapy to determine the behaviors that reflect caring. Based on the purpose of this pilot study, we sought to answer the following questions. Are therapists exhibiting caring behaviors? Second, is our caring consistent with the sample indicators set forth by our professional organization? Third, is caring the same across all clinical settings and patient conditions?
This study was approved by the Institutional Review Board at Emory University. To develop a deeper understanding of caring behaviors in clinical practice from the perspectives of patients, a phenomenological research design was used. …