Want to improve physical therapy outcomes for patients with chronic diseases? Have a "calmer, more relaxed, secure, and resilient" personality, according to Dutch researchers.

In an article published in the December 16 issue of BioMed Central's Health Services Research, researchers from the Netherlands compared treatment outcomes from patients with chronic disease such as arthritis, cardiovascular disease, cancer, chronic respiratory disease, and diabetes with the ways their treating physiotherapists (PTs) scored on "The Big 5" Index (BFI), a widely used personality test (you can take the test here).

Authors of the study hoped to get a full picture of how the 5 personality dimensions measured in the test—neuroticism, agreeableness, conscientiousness, extraversion, and openness to experiences—played into patient outcomes. In the end, they found that only neuroticism seemed to have an impact.

The neuroticism scale is essentially a measure of emotional stability, impulse control, and the tendency to express unpleasant emotions. A lower neuroticism score indicates "being more calm, relaxed, secure, and hardy," according to the study's authors.

What researchers found was that worse patient outcomes seemed to be linked to PTs with a higher neuroticism score. The lack of any measurable link between the other personality dimension scores and outcomes "contradicts previous research in psychotherapy suggesting that traits including being empathetic, cautious, non-intrusive, respectful, being able to adjust, and exuding warmth … improve treatment outcomes," authors write.

Treatment outcomes were measured using the Numeric Rating Scale (NRS), a "widely used Dutch outpatient practice tool for evaluating treatment effect by looking at the course of complaints during treatment." Scores were recorded at the beginning and end of physical therapy.

In addition to scores on the personality test, researchers also looked at whether the PT experienced a "major life event" (a yes/no question with no accompanying explanation from the PT) during the past 3 years, as well as demographic features of the PTs. They found that having experienced a major life event correlated to better patient outcomes, as did being a male PT, but cited few reasons for the connections.

Authors admit that the voluntary nature of the study led to a significant amount of missing data and relatively small PT sample size (39). They also acknowledge that there may be better personality tests but that the BFI was chosen "for practical reasons, since it does not take too long for a therapist to fill out."

Despite these limitations, authors assert that their study supports the idea that "if a therapist does not feel mentally stable, it is reasonable to assume that this might have consequences for his or her attitude when interacting with the patient."

Authors suggest that more research into personality dimensions could underscore the importance of self-reflection among providers—and the development of educational components that strengthen this ability.

"Tools like communication skills training might be used as supplement to reflection, but [we] believe that self-awareness and reflection training during the early stages of study are needed before these tools can be used effectively," they write.

APTA emphasizes the importance of prevention, wellness, and disease management, and offers resources for physical therapists (PTs) and their patients at MoveForwardPT.com in addition to online continuing education on disease management models. This year, the APTA House of Delegates emphasized the PT's important role in chronic disease management and treatment by adopting an official position titled "Health Priorities for Populations and Individuals" (RC 11-15).

Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.