Evaluation of the impact of motivational interviewing by a physiotherapist on the older patient's participation in the rehabilitation program and the care relationship: the MOTIV-Age qualitative study.

OBJECTIVES

Although motivational interviewing (MI) has shown benefits in younger patients with long-term conditions or older patients in hospital settings, we investigated the experienced impact of MI delivered by a physiotherapist (PT) on community-dwelling older patients' engagement in rehabilitation.

DESIGN

Qualitative study following the descriptive-interpretive concept.

SETTING AND PARTICIPANTS

The study was conducted in a suburban area of Paris. Participants were community-dwelling older adults aged over 75 years who consulted the same PT for musculoskeletal disorders and/or functional decline. There were no other inclusion or exclusion criteria.

METHODS

Data collection included a PT logbook documenting observations before and after MI and semi-structured individual interviews (SSIIs) conducted by two independent investigators. Analyses involved using interpretative phenomenology and Miles & Huberman's recommendations.

RESULTS

From June to July 2024, we included 10 patients (mean age 88±4.2 years, 90% female, median Activities of Daily Living score 5.5 [interquartile range 5.0-5.5]); six had SSIIs. The PT reported that MI seemed to enhance engagement in rehabilitation for some participants. MI facilitated open communication and emotional expression and strengthened the therapeutic alliance, improving the PT's ability to personalize care, set goals, plan treatment and communicate with patients. Patients valued the PT's professionalism and empathy, viewing the PT as a key figure in maintaining their autonomy.

CONCLUSIONS AND IMPLICATIONS

This study provides preliminary evidence supporting the integration of MI into routine physiotherapy for community-dwelling older adults. MI shows promise for enhancing patients' engagement in physical activity and improving the PT clinical practice.