The experiences of physiotherapists delivering pain science education via an interpreter: a mixed-methods online survey

Physiother Theory Pract. 2024 Sep 12:1-10. doi: 10.1080/09593985.2024.2396553. Online ahead of print.

Abstract

Objective: To explore physiotherapist's experiences of delivering Pain Science Education (PSE) via an interpreter to people with persistent pain.

Method: A cross-sectional online survey study of UK Physiotherapists. The study protocol was registered on the Open Science Framework Registry. Seventy-seven physiotherapists with experience of delivering PSE via an interpreter completed the survey between January 16, 2023 and May 24, 2023. Feelings of stress and confidence the messages of PSE had been understood when delivering PSE with and without an interpreter were assessed on an 11-point Likert scale. In addition, drop-down, multi-selection lists were presented with barriers and facilitators to delivering PSE via an interpreter. Thematic analysis was undertaken of open text fields which allowed participants to elaborate on their responses.

Results: Physiotherapists were less confident the information had been understood -2.3 (-2.8 to -1.8) mean difference (95% Confidence Interval) and more stressed 2.3 (1.7 to 2.9) when delivering PSE via an interpreter compared to doing so without an interpreter (p < .001). From the open-text data, the overarching theme was Trust in the Interpretation with three sub-themes: 1) Family vs Professional Interpreter, 2) Therapist and Interpreter Relationship, and 3) Strong Preference for Face-Face Interpretation.

Conclusions: UK Physiotherapists are less confident that patients understand the messages of PSE when delivered via an interpreter and they find it significantly more stressful than delivering PSE in English. Almost all participants encountered barriers to delivering PSE via an interpreter. Future research needs to explore the experience of patients and interpreters within this clinical context.

Keywords: Pain; health education; limited English proficiency; survey.