Fysioterapeuten (Oct 2021)
The patient as a person in patient centered physiotherapy
Abstract
Introduction: A patient centered approach has gained increased interest, and discussions are raised about the meaning of a patient centered approach in clinical practice. This article focuses on how the patient, which the treatment is centered on, is understood as a person in physiotherapy. The aim is to provide new insight into what patient-centered physiotherapy may be. Main part: Drawing on Kristeva’s discussions on subjectivity in the medical discourse and a previous study of physiotherapists’ treatment narratives, the article highlights two conflicting concepts of the individual patient inherent in patient centered care: one the one hand, the patient is seen as a singular, vulnerable, and bodily subject in motion. The treatment is an open process based on interaction and an openness to search for meanings. On the other hand, the person in the center of treatment was defined according to ideal images of the “successful patient”; a rational, motivated and independent individual. The treatment is seen as a goal-oriented intervention. Drawing on Mattingly’s perspectives and the concept of “therapeutic emplotment” I argue for patient centered physiotherapy as a narrative practice – a story in-the-making. Conclusion: A one-sided focus on treatment outcomes may conceal healing aspects of physiotherapy; moments in which the patient experiences him or herself and his or her body in new ways and gain new strength to continue on the long, tortuous and endless path that recovery may be.
