Example convergence matrix.

IntroductionLow back pain (LBP) is the leading cause of disability worldwide, with high prevalence in Canada and the United Kingdom. LBP care pathways offer high-quality, guideline concordant care, with advanced practice physiotherapy (APP) an integral component. APP is a higher level of practice providing care for individuals with complex healthcare needs. Patient experience is an important measure of healthcare service quality. Although patient experience has been explored in some APP settings, and in standard physiotherapy for people with LBP, no study has explored patient experience of APP in LBP care pathways.Aim & ObjectivesTo explore and understand how patients experience APP within low back pain care pathways in the UK and Canada. To map APP integration within LBP care pathways in the UK and Canada. To explore advanced practice physiotherapists’ perspectives on the patient experience of APP. To explore patients’ experience of APP. To synthesise the physiotherapists’ perspectives on the patient experience and patients’ experience of APP. To compare patient experience of APP between the UK and Canada.MethodsA qualitative, exploratory, multiple case-study using an embedded (nested) design situated within a constructivist paradigm will be conducted. Cases will be LBP care pathways in Ontario, Canada and England, United Kingdom. AP physiotherapist and patient participants from both cases will be recruited through non-probability sampling. LBP care pathways will undergo framework analysis, quantitative questionnaire data will be reported descriptively, and interview and open text questionnaire data will undergo thematic analysis. Both within-case and cross-case analyses will be conducted.SignificanceThis study may improve patient-centred care in LBP care pathways, inform APP educational programs and curricula design, address a knowledge gap in the APP literature, and inform future research by offering theoretical propositions relevant to patient experience of APP within LBP care pathways.引言 下腰痛（Low Back Pain, LBP）是全球范围内首要的致残原因，在加拿大与英国患病率颇高。下腰痛照护路径可提供符合临床指南的高质量照护，其中高级实践物理治疗（Advanced Practice Physiotherapy, APP）是不可或缺的组成部分。高级实践物理治疗属于更高阶的执业范畴，用于照护存在复杂医疗需求的个体。患者体验是评估医疗服务质量的重要指标。尽管已有部分研究针对高级实践物理治疗场景，以及针对下腰痛患者的常规物理治疗场景开展了患者体验相关探索，但目前尚无研究针对下腰痛照护路径中高级实践物理治疗的患者体验展开探讨。 研究目的与目标 1. 探索并理解英国与加拿大的下腰痛照护路径中，患者对高级实践物理治疗的体验； 2. 梳理英国与加拿大下腰痛照护路径中高级实践物理治疗的整合情况； 3. 探索高级实践物理治疗师对下腰痛照护路径中患者体验的看法； 4. 探索患者在高级实践物理治疗中的体验； 5. 综合物理治疗师关于患者体验的观点，以及患者自身对高级实践物理治疗的体验； 6. 对比英国与加拿大两地患者对高级实践物理治疗的体验差异。 研究方法 本研究将采用建构主义范式下的嵌入（嵌套）设计，开展一项质性、探索性多案例研究。研究案例为加拿大安大略省与英国英格兰的下腰痛照护路径。将通过非概率抽样方法，招募两个案例场景中的高级实践物理治疗师与患者作为研究参与者。本研究将对下腰痛照护路径开展框架分析，对定量问卷数据进行描述性统计报告，对访谈与开放式文本问卷数据开展主题分析。同时将开展案例内分析与跨案例分析。 研究意义 本研究有望改善下腰痛照护路径中的以患者为中心的照护，为高级实践物理治疗的教育培训项目与课程设计提供参考，填补高级实践物理治疗相关文献中的知识空白，并通过提出与下腰痛照护路径中高级实践物理治疗患者体验相关的理论命题，为未来研究提供借鉴。