|dc.contributor.author||Øien, Aud Marie||eng
|dc.identifier.isbn||978-82-308-1571-7 (print version)||eng
|dc.description.abstract||The aim of the present thesis is to enhance knowledge of processes of change and
communication during long-term Norwegian PsychoMotor Physiotherapy (NPMP)
treatments for patients with chronic muscle pain located to back and/or neck. In the
following three separate studies, different types of change and communication are
investigated on the basis of a longitudinal research design, including observations of
treatment sessions, semi-structured interviews with patients and physiotherapists and
personal notes written by patients.
Self-narratives on the foundation of patients’ bodily experiences of movement
and breath prior to and through long-term NPMP treatment were investigated
based on a multiple case study of two cases.
Development and perception of change of movements and breath were explored
during NPMP treatment based on a multiple case study of nine cases.
Communication about change in demanding NPMP Physiotherapy treatment
situations was explored in a multiple case study of eleven cases.
Study I highlights the concomitant development of self-narratives and bodily
experiences on the basis of the dialogue between the patient and the physiotherapist.
The main narratives at the start and at the end of the monitored period describe the
patients’ experiences from being divided in body and mind to experiencing the body as
awakening. This change appears as a move towards a growing variety of selfnarratives,
and is related to an increasing awareness of limited bodily experiences of
movements and breath. The slow shift of the narratives – from being detached from
the body to being in touch with the body – captures these processes.
In study II, the exploration of the patients’ bodily changes during NPMP treatment
resulted in four patterns of change connected to movements, breath, reflections and
transfer of experiences from the treatment context to contexts outside treatment. The
fifth, to be detached from and to be in touch with the body, emerged interwoven in each of the above mentioned patterns. Two patient groups, the limited and the
considerable change group, were identified on the basis of the extent of change of the
different patterns. Across the particular patterns and groups, the way patients
perceived their bodies appeared as the core element for predicting change as well as
change in the making.
In study III, the investigation of communication with regard to change in demanding
treatment situations resulted in the identification of patterns of negotiation between the
physiotherapist and the patient. The identified main pattern was: seeking common
ground – a demanding negotiation process. This pattern was interrupted by short
episodes of challenging obstructions to change; the pattern of ambivalence and
uncertainty, and the pattern of impatience and disagreement. The physiotherapist’s
sensitivity of the situation and her/his capability of negotiation created possibilities for
change. So did the physiotherapists’ and the patients’ capacity to bear and come trough
demanding situations. The participants’ negotiation of the physiotherapeutic tasks, the
emotional aspects of the tasks, and the nature of the therapeutic relationship, seemed to
emerge as processes of change. Change and communication appeared integrated.
The studies demonstrate that knowledge about change and communication in NPMP
treatment of patients with chronic muscle pain of back and/or neck are built on
detailed step-by-step processes of perceiving and creating meaning to an increasing
variety of movement and breath. In the study, these processes were closely related to
how the patient and the physiotherapist negotiated details by varying their ways of
communication. Based on the knowledge-producing processes, the patients explored
new ways of moving and understanding. Concomitantly, reflections on the application
of new knowledge in different contexts outside treatment took place.||en
|dc.publisher||The University of Bergen||eng
|dc.relation.haspart||Paper I: Øien, A.M., Iversen, S., & Stensland, P. (2007). Narratives of embodied experiences – Therapy processes in Norwegian psychomotor physiotherapy. Advances in Physiotherapy, 9(1), 31-39. Full text not available in BORA due to publisher restrictions. The article is available at: <a href="http://dx.doi.org/10.1080/14038190601152115" target="_blank"> http://dx.doi.org/10.1080/14038190601152115 </a>||eng
|dc.relation.haspart||Paper II: Øien, A.M., Råheim, M., Iversen, S., & Steihaug, S. (2009). Self-perception as embodied knowledge – Changing processes for patients with chronic pain. Advances in Physiotherapy, 11(3), 121-129. Full text not available in BORA due to publisher restrictions. The article is available at: <a href="http://dx.doi.org/10.1080/14038190802315073" target="_blank"> http://dx.doi.org/10.1080/14038190802315073</a>||eng
|dc.relation.haspart||Paper III: Øien, A.M., Steihaug, S., Iversen, S., & Råheim, M. (2011). Communication as negotiation processes in long-term physiotherapy: A qualitative study. Scandinavian Journal of Caring Sciences, 25(1), 53-61. Full text not available in BORA due to publisher restrictions. The article is available at: <a href="http://dx.doi.org/10.1111/j.1471-6712.2010.00790.x" target="_blank"> http://dx.doi.org/10.1111/j.1471-6712.2010.00790.x</a>||eng
|dc.title||Change and Communication. Long-Term Norwegian PsychoMotor Physiotherapy Treatment for Patients with Chronic Muscle Pain||eng
|dc.subject.nsi||VDP::Medical disciplines: 700::Health sciences: 800::Physiotherapy: 807||eng
|dc.rights.holder||Copyright the author. All rights reserved||