The many different forms of patient distress: An emotional challenge for physiotherapists

Aim: To explore physiotherapists’ perceptions of, and experiences with patients experiencing psychological distress.

Design: Interpretivist qualitative paradigm. Method: Twenty-three Australian physiotherapists each participated in an in-depth interview. Eleven different areas of practice were reflected in the sample. Data were analysed using Iterative Thematic Inquiry.

Results: Two overarching themes were co-constructed. The first theme, Encounters with patients in distress are common and varied, captured participants' perceptions of patients experiencing psychological distress. Participants perceived patient distress to be multifaceted and multifactorial. Salient forms of patient distress reported by participants included anticipatory anxiety, grief, and profound hopelessness. Participants felt that for those patients experiencing more severe distress, there was often an associated element of trauma. The second overarching theme, The emotional toll of practice, revealed the emotional impact participants experienced as a result of encountering patients in distress. Participants reflected that connecting with patients on an emotional level could invoke distress in themselves and that repeated empathetic distress could have serious personal and professional consequences.

Conclusion: The nature of the forms in which patient distress may manifest is varied. Patient distress has the potential to invoke transient, and in some instances more persistent, empathetic distress in physiotherapists and poses a significant clinical and personal challenge for physiotherapists.

Key Practice Points:
• Patient distress is common and presents in many forms.
• Physiotherapists experience empathic distress in response to patient distress. • Physiotherapists may benefit from self-care to manage the emotional toll.