Experiences, barriers and needs of physiotherapists with regard to providing self-management support to people with low back pain: A qualitative study. (December 2021)

• Record Type: Journal Article
• Authors: van den Heuvel, Charlotte; van der Horst, Jorn; Winkelhorst, Eva; Roelofsen, Eefje; Hutting, Nathan
• Is Part Of: Musculoskeletal science and practice. Volume 56(2021)
• Publication Date: 2021-12
• Subjects: Self-management -- Low back pain -- Physiotherapy; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2021.102462
• Languages: English
• ISSNs: 2468-8630

Abstract

Abstract: Background: A person-centred, biopsychosocial approach focused on self-management and a healthy lifestyle is recommended for managing non-specific low back pain (LBP). Objective: What are the experiences of physiotherapists with regard to providing self-management support to people with non-specific LBP? Design: Exploratory qualitative. Methods: Fourteen semi-structured interviews were conducted with physiotherapists in the Netherlands using a semi-structured and pilot tested interview guide. Data were analysed using inductive thematic analysis. Results: Physiotherapists believe that self-management has added value in the management of people with non-specific LBP. Motivational interviewing, providing advice and exercise were most frequently used to facilitate behaviour change aimed at enhancing patients' self-management. Support regarding self-management skills was not frequently mentioned. Physiotherapists are not fully aware of and do not fully integrate support with regard to important self-management skills. The most important barrier participants experienced with regard to integrating self-management was patient expectations. Another important barrier was addressing psychosocial factors. Most participants expressed a need to better integrate self-management support in their treatment. They explained that they needed more knowledge (courses, knowledge clips), opportunities to exchange experiences (peer review group) and tools for patients (app). Conclusions: Physiotherapists do not fully integrate support with regard to important self-management skills in people with non-specific LBP. We recommend that physiotherapists address the identified barriers and needs and better include self-management support in their treatment of people with non-specific LBP. We recommend important stakeholders to collectively work on diminishing barriers to integrating self-management support. Highlights: Physiotherapists believe that self-management support is important in people with low back pain. Physiotherapists do not fully integrate support with regard to important self-management skills. Integrating self-management support is often difficult and does not work well enough for all patients. The most important barrier with regard to integrating self-management was patient expectations. Physiotherapists need knowledge, opportunities to exchange experiences and tools for patients.