Published: 27-02-2016 09:58 | Updated: 13-10-2017 15:55

From clinical expert to guide – How physical therapists’ learn to support health-enhancing physical activity behaviours in people with rheumatoid arthritis (RA)

What are the physical therapists’ experiences and how do they behave supporting behavior change in people with RA after a preparatory education and training? This is the subject of a new thesis from PhD student Thomas Nessen at the Division of Physiotherapy.

Thomas Nessen.Further information on the dissertation on March 3, 2016.

What´s the main focus of your thesis?

How physical therapists experience and adopt a biopsychosocial approach guiding people with rheumatoid arthritis (RA) to health-enhancing physical activity, this during a one-year intervention study. In addition, measurement properties of a scale to assess exercise self-efficacy (belief in one’s capability to perform a certain behavior in a specific situation) in RA were investigated.

Which are the most important results?

The results indicate that it is challenging to adjust to a new role to guide behavior change. The physical therapists needed to handle challenges on how to deal with expectations from the intervention participants, and situations when the participants did not adhere to the physical activity program. The physical therapists gradually grew into the role and became more comfortable to use the behavior change techniques in the intervention. The education the physical therapists received provided support to apply the new role and feedback on their own behavior was considered important. The measurement properties in the exercise self-efficacy scale indicated respectable reliability, while the hypotheses for construct validity were only partially supported.

How can this new knowledge be useful for people, or contribute in improving their health?

Health care professionals which are able to integrate and apply both medical and behavioral knowledge may provide better support to change health behaviors in patients. The educational model evaluated in this study contained theoretical and practical components with emphasis on practical exercises and individual feedback. The results indicate that this educational model works well, even though it needs to be tested and evaluated in other contexts.

What´s in the future for you? Will you keep on conducting research?

I am moderating a MOOC course at Karolinska Institutet and am looking for new opportunities both within and outside the research field.


Learning to guide behavior change : physical therapists’ promotion of health-enhancing physical activity in people with rheumatoid arthritis