Biomedical subjects

E Thornquist

Publications and source records attributed to E Thornquist.

11 recordsLinked to original sources

PubMed1998

[Physiotherapy practice--examination and patient participation].

Musculoskeletal disorders are increasing; they require vast resources and are controversial. How are patients suffering from such disorders received, examined and understood? This article is based on a research project of first-time consultations in a physiotherapy practice, using video recordings and direct observations, supplemented by interviews. One particular encounter is described and analysed in detail. The analysis shows that most of the consultation was devoted to verbal communication and that the information obtained by verbal exchange and physical examination overlapped. The therapist stressed the relationship between the general state of the body and local conditions and regarded the body as a field of expression. Since the patient is affirmed as an experiencing body subject entitled to opinions, her participation is encouraged. A common ground for future co-operation is established. The findings emphasize the need for further analysis of actual practice and ist underlying assumptions. Microstudies of clinical consultations can teach us more about the relationship between diagnostics and the prerequisites for ensuring patients' participation.

Communication↗

PubMed1997

Three voices in a Norwegian living room: an encounter from physiotherapy practice.

This article demonstrates how uses of the body regulate togetherness and availability in clinical encounters. A first encounter between a physiotherapist and a married couple in their home is analyzed. The husband suffers from functional consequences of a stroke. The therapist's job is to assess his functional capacity and determine how he can best be helped. The article centers on the process of interaction, specifically on verbal and bodily actions pertaining to developing role negotiations. Comprehensive excerpts demonstrate that a struggle is going on between the husband and wife over the management of information about his condition. This imposes dilemmas of control and caring on the therapist. The article describes the maneuvering of the parties and shows how the therapist manages her professional tasks. Emphasis is placed on the particular predicaments that a clinical encounter can generate in a private residence, and on how clinical tasks are embedded in social processes. Finally, the article questions the (often tacit) analytical assumption that "interaction" and "diagnostics" are separate phenomena, and shows how the understanding of both can be advanced if seen as mutually constitutive processes.

Aged↗

PubMed1994

[Recognition and dependency. When patients and health personnel meet].

The article is based on a research project on first encounters in physiotherapy practice, using video recordings and interviews. A single encounter is described and analysed in detail: How conditions for co-operation evolve during the course of the encounter is analysed by focusing on dialogue and bodily interaction. The therapist directs her attention to the patient's immediate trauma ("whiplash"). The analysis shows that she expresses interest and recognition through her bodily actions and clinical performance, while her words and the focus of her examination have the effect of curbing the patient's participation. A giver-receiver relationship is established, where the therapist and patient reinforce each other in an active-passive division of roles. Recognition and dependency are discussed in the context of asymmetric relationships, role distribution and professional identity.

Communication↗

PubMed1994

Profession and life: separate worlds.

How do physiotherpaists relate to and examine patients? This question was the point of departure for this article and it immediately gave rise to another: what is the relationship between professional knowledge and general experience? Data were collected as part of a project where encounters between patients and physiotherapists are analysed. The encounters were directly observed and video-taped, and the participants individually interviewed afterwards. The article is based on a detailed analysis of two encounters. It is shown how both therapists direct their examination towards local symptoms and conditions; the emphasis being on joint mobility. The information obtained is adapted to the therapists' biomedical frame of reference. Their interpretations, assessments, and treatment proposals are well within the same frame. In this way historical and clinical data are not 'revealed' but rather constructed; a process which helps transform the patients' problems to solvable problems--for the therapists. Despite the fact that the conception of the body implicit in their diagnostic practice was dualistic, both therapists related to their patients as embodied subjects in many of their general actions. They examined the body as a physical object extrinsic to the self and added the human factor by being interested in the patients as persons through general communication actions. It is argued that the discrepancy between these two views of the body justifies the conclusion that the therapists were operating with unintegrated worlds of knowledge. The findings are interpreted in light of general perspectives on the relationship between general and particular knowledge, between the 'scientific' context-free attitude and every-day contextualized knowledge.

Attitude of Health Personnel↗

PubMed1994

Varieties of functional assessment in physiotherapy.

OBJECTIVE: To increase our knowledge about the diagnostic process in physiotherapy and to identify possible differential frames of reference. DESIGN: Video-recordings and semi-structured interviews of the participants. SETTING: Natural working settings, i.e. private institutes and patients' homes. PARTICIPANTS: Manual, psychomotor, and district (visiting) therapists. RESULTS: The three categories of therapists use different approaches and operate within different interpretative frames throughout. They direct their attention towards different aspects of the patient's body, function, and life situation, they interpret information differently, they conclude their examinations in different ways, and suggest different treatments. The observed dissimilarities are generally mirrored by the therapists' verbal statements. But certain discrepancies between actions and statements are also found. CONCLUSION: This study shows how practice and the way of thinking can differ among physiotherapists. Renewed reflection on actual practice is called for, and the diagnostic process should be approached as an active interpretive enterprise.

Activities of Daily Living↗

PubMed1992

[To see the body with new eyes].

The conception of the body underlying medical theory and practice is considered and compared with the conception obtained from everyday experience and that expressed in art. Recent medical "holism" is characterized as dualism in disguise. The alternative to the biomedical model cannot be to relinquish the body, to redefine patients' problems as "psycho-social", and reduce health-work to talk, which is the latest trend in general practice. The alternative is rather to regard the body anew; to take other people's experiences of life seriously and not deprive the body of intention and meaning. This view of the body--qualitatively different from the one prevailing in medicine--is advocated as a prerequisite for a much-needed recontextualisation of consultations and thereby for a new understanding of today's health-problems.

Anthropology, Cultural↗

PubMed1992

Examination and communication: a study of first encounters between patients and physiotherapists.

What happens in first encounters between patients and physiotherapists? Videotaped encounters between two patients and their physiotherapists were analysed in depth to try to answer this question. It is advocated that attention must not be restricted to either clinical decision making or communication, but needs to be directed towards the relationship between communication and diagnostic approaches. In other words, in order to understand how a health problem is defined, the complexity and social organization of the process of interaction cannot be ignored. Therapies are chosen and cooperation is built on such socially and professionally constructed basis, and it is suggested that the nature of this construction needs to be grasped. To this end, the author analyses both the therapists' examination and the communication between patient and therapist. Focus is thereby shifted from the 'pure' diagnostic activity to the frame of reference underlying it. The analysis demonstrates differences in the two therapists' practice from the very moment patient and therapist greet one another till they say farewell. The therapists' actions mirror the dissimilar conceptual frameworks underlying their practice, and the therapists' conceptual lenses therefore need to be scrutinized further.

Attitude to Health↗

PubMed1991

[Different arenas--what significance does this have for physiotherapeutic practice?].

What aspects of the patient's body, way of functioning and life situation fall within or outside the physiotherapists' field of inquiry? This is one of the main questions in a research project to analyse first encounters in physiotherapy practice, based on videotapes of the encounters and semi-structured interviews. The article focuses on the relation between the examination approach, communication, and the setting of the encounters. Data from two of the videotaped encounters are used as a basis for a more general presentation and discussion. One of the findings was that the setting of the encounters influenced the professional's attention in some way or other, and had a significant effect on the information acquired and on the relationship that developed between the two parties. It appears that the orientation and real practice of a professional need to be interpreted in the context of institutional and external factors and of the ongoing interaction developed in the situation.

Communication↗

PubMed1991

Body communication is a continuous process. The first encounter between patient and physiotherapist.

First encounters between patients and physiotherapists have been video-taped and analysed as part of a research project encompassing manual, psychomotor, and district physiotherapists. The main focus in this article is on body communication. The common features and differences between the patterns of communication established by the three categories of therapists are described and compared. Since human beings function and relate to each other as physical subjects, messages of interest and involvement will in some way be conveyed through their bodies. The recognition of this fact means that body communication is a central aspect of patient-centredness. The relationship, context, and actual basis of cooperation can only be understood by analysing the way in which professionals relate to their patients through their bodies. This is because body messages are conveyed continuously in any encounter between two people, while verbal communication is discontinuous.

Communication↗

PubMed1990

[What happens during the first encounter between a patient and a physiotherapist?].

Doctors refer several patients with problems connected to muscles and joints to physiotherapists. What happens when the patient meet the physiotherapist? This question is the starting point for a research project on first encounters in physiotherapy practice focusing on function assessment and communication. The analysis is based on videotapes of the encounters and semistructured interviews with patients and physiotherapists. This article is based on one of the videotaped encounters. The analysis assumes that all actions convey messages. Professional actions are interpreted in a communicative perspective. It appears that the patient's presentation of her problems is to some extent excluded from the therapeutic frame of understanding. The encounter displays problems and challenges between the person seeking help and the professional

Humans↗

PubMed1990

Communication: what happens during the first encounter between patient and physiotherapist?

First encounters between patients and physiotherapists have been video-taped and analysed as part of a research-project. Emphasis was on both functional assessment and patterns of interaction. Three groups of physiotherapists participated; manual therapists, psychomotor therapists, and district physiotherapists. The three groups used different approaches when examining their patients. Thus they conveyed different messages of content, roles, and relationships. Commonly, communication is discussed and analysed separately from diagnostic and therapeutic activity. Rejecting such separation, it is argued that it is important to highlight the way in which physiotherapists relate to their patients through their professional actions. The focus in this article is the implicit communication in the physiotherapist's examination. For physiotherapists, as for doctors, the body is the basis of their work. It is emphasized that it is especially important to discuss the body in connection with implicit communication.

Communication↗