Physiotherapists’ attitudes and beliefs about low back pain influence their clinical decisions and advice

Christe, Guillaume (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Swiss BioMotion Lab, Department of Musculoskeletal Medicine, University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland) ; Nzamba, Jessica (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Desarzens, Ludovic (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Leuba, Arnaud (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Darlow, Ben (Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand) ; Pichonnaz, Claude (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Department of Musculoskeletal Medicine, University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland)

Background Physiotherapists' biomedical orientation influences the implementation of evidenced-based care for low back pain (LBP) management. However, information on physiotherapists’ own beliefs about their back and LBP and the influence of these on clinical decisions and advice is lacking. Objectives To identify attitudes and beliefs about LBP among physiotherapists and to analyse the association of these beliefs with physiotherapists’ individual characteristics and clinical decisions and advice. Design Cross-sectional survey. Method Attitudes and beliefs about LBP were measured with the Back-Pain Attitudes Questionnaire (Back-PAQ) among French-speaking Swiss physiotherapists. Physiotherapists’ clinical decisions and advice were assessed with a clinical vignette to determine their association with the Back-PAQ score. Results The study included 288 physiotherapists. The mean Back-PAQ score (82.7; SD 17.2) indicated the presence of helpful beliefs in general, but unhelpful beliefs in relation to back protection and the special nature of LBP (nature of pain, impact, complexity) were frequently identified. Individual characteristics explained 17% of the Back-PAQ score. Unhelpful beliefs were associated with clinical decisions toward back protection and movement avoidance (r = - 0.47, p < 0.001). Conclusions While helpful beliefs and guidelines consistent decisions were generally identified, unhelpful beliefs about back protection and the special nature of LBP were frequently present among physiotherapists. These unhelpful beliefs were associated with less optimal clinical decisions. Educational approaches should challenge unhelpful beliefs and empower physiotherapists to provide explanations and management that increases patients’ confidence in the back. Future research should investigate the effect of educational strategies on implementation of best practice for LBP management.


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Physiothérapie
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2021-06
Pagination:
8 p.
Published in:
Musculoskeletal science and practice
Numeration (vol. no.):
June 2021, vol. 53, article 102382
DOI:
ISSN:
2468-7812
Appears in Collection:



 Record created 2021-05-10, last modified 2021-05-25

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