Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists
Received: October 1, 2014; Received in revised form: March 23, 2015; Accepted: April 2, 2015; Published Online: April 14, 2015
Highlights
- •Patients perceived negative weight judgments from some physiotherapy interactions
- •This may result in poorer patient outcomes and avoidance of physiotherapy
- •Awareness of this means that physiotherapists can be more sensitive to this issue
- •Suggested strategies include collaborative communication, avoiding blaming patients
- •Also not talking weight when patients are undressed and minimising use of mirrors
Abstract
Background
Weight management is increasingly considered part of physiotherapists’ scope of practice in order to improve patient outcomes by, for example, reducing load on joints, or improving chronic pain. However, interactions with patients involving weight may result in patient perceptions of negative judgment from health professionals, which can result in poorer health outcomes. How physiotherapist/patient interactions involving weight are perceived by patients has not yet been investigated.
Objectives
To explore patients’ perceptions of interactions with physiotherapists that involved weight, and investigate how these perceptions may inform physiotherapy practice.
Design
Face-to-face interviews with physiotherapy patients, with follow up interviews conducted by telephone. Data were analysed thematically.
Method
First interviews were held in a physiotherapy practice with follow up interviews conducted two weeks later. Interviews were audio recorded, transcribed and analysed using an inductive thematic method established by Braun and Clarke.
Findings
Thirty interviews with 15 patients were analysed. Four main themes relevant to weight were identified: 1) perceptions of being ‘in physiotherapy’ including pre-conceptions, the physical environment, and exposing the body, 2) emphasis placed on weight in physiotherapy interactions, 3) communication styles, and 4) judgment perception.
Conclusion
Some patients perceived negative weight judgments from elements of physiotherapy interactions and environments. Physiotherapists need to be aware of this perception because it may result in poorer patient outcomes and patients avoiding physiotherapy appointments. The results suggest strategies to counteract weight stigma include: adjusting the physical environment of the clinic, portraying an understanding of complex determinants of weight, and employing collaborative, non-judgmental communication styles.