Educating patient educators: enhancing instructional effectiveness in physical therapy for low back pain patients

The objective of this research project was to study the effectiveness of a training program for the enhancement of patient education skills in physica l therapy. In this paper the improvement of five of these skills is tested. These skills are aimed at a better monitoring of adherence problems during the treatment and at enhancing self-efficacy of the patient after treatmen t. In order to test the effectiveness of the program, complete treatments o f 19 physiotherapists have been assessed before (1142 sessions, 130 patient s) and after (775 sessions, 88 patients) the training program. Information on the instructions and solutions given to the patients was obtained with a registration form, completed after each session by the physiotherapist. Th e patient's perception of the effectiveness and feasibility of instructions was obtained from questionnaires, completed by the patient on three occasi ons. After the training only a minority of the trained skills appeared to b e improved. All in all, the training program was not very effective. More e ffort is needed to develop training programs aimed at promoting patients' s elf-efficacy as well as measurement instruments to assess the effects of su ch programs. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.