Background Low back pain (LBP) is the leading cause of disability worldwide. Patient education and self-management have the potential to improve the care of patients. However, little available time for consultations challenge the delivery of optimal care in general practice. Involving clinical staff members in the management of diabetes and of patients with hypertension has shown to be feasible. Consequently, involving clinical staff members in providing education and information to patients may improve the delivery of patient information and education. However, this require a shift in the division of tasks and general practitioners’ (GPs’) barriers and facilitators for this is currently unknown. The aim is to explore GPs’ experiences of including clinical staff members in the management of LBP. Methods This is a qualitative, semi-structured interview study. We used a phenomenological approach to guide the data collection and the analysis in order to gain insight into the subjective experiences of the GPs and to understand the phenomenon ‘delegating tasks to practice staff’ from the GPs’ lifeworld. Analysis was conducted using inductive descriptive methods. Results We conducted five 60-minute interviews with Danish GPs. All GPs had experience with task delegation, but it varied which tasks the GPs delegated and to which types of clinical staff members. The following barriers towards clinical staff member involvement were identified: Patients with LBP is a heterogeneous group with a variety of treatment needs, the examination and treatment can be considered as one coherent process, and it would require external support. Involving clinical staff members can release GP time. Another facilitator was the possibility for improving the uptake of clinical guidelines and involvement of practice nurses was considered to improve the provision of patient education and lead to greater patient self-management. Conclusion While some GPs currently consider delegation to clinical staff members a good idea in the treatment of LBP, others prefer the existing treatment strategy without clinical staff member involvement. Consequently, healthcare providers need to address existing barriers and facilitators for involving clinical staff members when advocating for a future multi professional treatment strategy of LBP in general practice. Trial registration Not applicable.
Objectives: Involving practice nurse and other assistant clinical staff members in providing information and education to patients with low back pain at follow-up appointments may release more time and improve care in general practice. However, this requires a shift in the division of tasks, and general practitioners’ barriers and facilitators for this are currently unknown. The objectives were to explore general practitioners’ experiences and perceptions of including assistant clinical staff members in the management of low back pain. Methods: This is a semi-structured interview study in Danish general practice. General practitioners with a variation in demographics and experience with task-delegation to clinical staff were recruited for in-depth interviews. We used a phenomenological approach to guide the data collection and the analysis in order to gain insight into the subjective experiences of the general practitioners and to understand the phenomenon of ‘delegating tasks to practice staff’ from the perspective of the general practitioners’ lifeworld. Analysis was conducted using an inductive descriptive method. The sample size was guided by information power. Results: We conducted five interviews with general practitioners. All general practitioners had experience with task delegation, but there was a variation in which tasks the general practitioners delegated and to which types of clinical staff members. The following themes were derived from the analysis: general practice organisation, delegating to clinical staff members, doctor–patient relationship, exercise instruction, clinical pathway for patients and external support. Conclusion: General practitioners consider patients with low back pain to be a heterogeneous group with a variety of treatment needs and a patient group without any predetermined content or frequency of consultations; this can be a barrier for delegating these patients to clinical staff members.
Background Low back pain (LBP) is the leading cause of disability worldwide. Patient education and self-management have the potential to improve the care of patients. However, high workload and little available time for consultations are argued to challenge the delivery of optimal care in general practice. Involving clinical staff members in the management of diabetes and of patients with hypertension has shown to be feasible. Consequently, involving clinical staff members in providing education and information to patients may improve the delivery of patient information and education. However, this require a shift in the division of tasks and general practitioners’ (GPs’) barriers and facilitators for this is currently unknown. The aim is to explore GPs’ barriers and facilitators to involve clinical staff members in the treatment of LBP in general practice. Methods This is a qualitative, semi-structured interview study. We used the phenomenological approach to study experiences and attitudes towards changing the management of patients with LBP from the GPs’ perspectives. Analysis was conducted using inductive descriptive methods. Results We conducted five 60-minute interviews with Danish GPs. All GPs had experience with task delegation, but it varied which tasks the GPs delegated and to which types of clinical staff members. The following barriers towards clinical staff member involvement were identified: Patients with LBP is a heterogeneous group with a variety of treatment needs, the examination and treatment can be considered as one coherent process, and it would require external support. Involving clinical staff members can release GP time. Another facilitator was the possibility for improving the uptake of clinical guidelines and involvement of practice nurses was considered to improve the provision of patient education and lead to greater patient self-management. Conclusion While some GPs currently consider delegation to clinical staff members a good idea in the treatment of LBP, others prefer the existing treatment strategy without clinical staff member involvement. Consequently, healthcare providers need to address existing barriers and facilitators for involving clinical staff members when advocating for a future multi professional treatment strategy of LBP in general practice.
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