• Rob Stenner, Annette Swinkels, Theresa Mitchell, and Shea Palmer.
• Orthopaedic Assessment Service, Somerset Partnership NHS Foundation Trust, 48 Parkfield Drive, Taunton, Somerset TA1 5BU, UK. Electronic address: robert.stenner@sompar.nhs.uk.
• Physiotherapy. 2016 Dec 1; 102 (4): 339-344.

BackgroundThe culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences.ObjectiveTo understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan.DesignA qualitative study using a philosophical hermeneutic approach.MethodsSemi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care.FindingsThe findings provide a detailed insight into patients' perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients' expectations and patients' needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual.ConclusionsShared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making.Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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