'I need to do another course' - Italian physiotherapists' knowledge and beliefs when assessing psychosocial factors in patients presenting with chronic low back pain. (February 2017) - Zangoni, Giacomo
Abstract: Objectives: Psychosocial factors play an important role in the development and subsequent recovery of individuals suffering from chronic low back pain (CLBP). The study explored physiotherapists' personal beliefs and knowledge about the biopsychosocial model and the different ways they assess and manage psychosocial factors in patients presenting with CLBP. Methods: Qualitative research design using semi-structured interviews and a constructivist grounded theory approach to data collection and analysis. A purposive sample of eight physiotherapists practicing in Italy and having experience with patients presenting chronic musculoskeletal problems were recruited from private clinics. Results: Three main categories were constructed: 1) conceptions of the biopsychosocial model and its role in CLBP; 2) evaluation and management of PS factors; 3) barriers in the assessment and treatment. Conclusions: Physiotherapists showed a basic knowledge of the biopsychosocial model and partially recognised social, emotional, cognitive and psychological factors in chronic low back pain patients, and their contribution in the individual patient's pain and disability. Physiotherapists highlighted the presence of barriers in the evaluation and treatment of people with CLBP, and some participants displayed a lack of skills to overcome these barriers. Physiotherapists perceived limited education and training to successfully address psychosocial factors in the management of patients with chronic low back pain, indicating the need to incorporate the biopsychosocial model in the daily practice and improve the training and education of the psychosocial assessment and management. Highlights: Italian physiotherapists possess a basic knowledge of psychosocial factors in relation to CLBP. Italian physiotherapists hold a range of beliefs in assessing PS in CLBP patients. Several barriers prevent Italian physiotherapists assessing PS factors in CLBP. These barriers may be a result of inappropriate education and training about the BPS model of care. Emphasis on PS factors relating to CLBP should in pre- and post-professional education in Italy.