Health care providers’ understanding of self-management support for people with chronic low back pain in Ethiopia: an interpretive description

Abstract

Background Healthcare providers play a key role in supporting people with chronic low back pain to self-manage their condition. The study aimed at exploring how health care providers understand and conceptualize self-management and how they provide self-management support for people with chronic low back pain in Ethiopia. Methods Health care providers who have supported people with low back pain, including medical doctors and physiotherapists, were approached and recruited from three hospitals in Ethiopia. This study employed an interpretive descriptive approach using semi-structured interviews. Findings Twenty-four participants (7 women; 17 men) with a median age of 28 (range 24 to 42) years and a median of 9.5 years (range 1 to 11 years) of helping people with chronic low back pain were interviewed. Seven major themes related to health care providers’ understanding of self-management support for people with chronic low back pain in Ethiopia emerged. The findings show that self-management was a new concept to many and health care providers’ had a fragmented understanding of self-management. They used or suggested several self-management support strategies to help people with CLBP self-manage their condition without necessarily focusing on enhancing their self-efficacy skills. The participants also discussed several challenges to facilitate self-management support for people with chronic low back pain. Despite the lack of training on the concept, the providers discussed the potential of providing self-management support for people with the condition. Conclusions Self-management was a new concept to health care providers. The providers lack the competencies to provide self-management support for people with chronic low back pain. There is a need to enhance the health care providers’ self-management support competencies through training.

Supported self-management in long-term conditions in an African context

“…Relationship development includes improving communication between patients and healthcare providers and deepening the understanding and acknowledgement of peoples’ situations and wider contexts by healthcare providers. Being patient- or person-centred is identified as facilitating supported self-management (Chala et al 2022 ; Diener 2021 ). However, healthcare providers’ attitudes towards and communication styles with patients impact relationships (Angwenyi et al 2019 ; Dube et al 2017 ; Masupe et al 2022 ) with ‘victim blaming’ noted as being unhelpful with people not being able to ‘self-manage by following a set of instructions.…”

“…The need to develop healthcare providers’ understanding of and competency in supporting patient self-management endeavours is evident in the included studies (Angwenyi et al 2019 ; Chala et al 2022 ; Diener 2021 ). As the:…”

“…However, primary care is often hampered by inadequate community services and staff shortages, so a recommended solution is to have dedicated community-based multidisciplinary healthcare teams with well-trained healthcare providers (Landu & Crowley 2023 ; Masupe et al 2022 ). However, there is a need to enhance self-management support training for and increase the competence of healthcare providers (Chala et al 2022 ; Landu & Crowley 2023 ). One innovative strategy employed is to train community health workers (CHW) in self-management skills for long-term health conditions to enable them to self-manage their health and those they support in the communities.…”

“…into Amharic), with overlapping concepts with self-care and self-treatment. There are diverse views of self-management support strategies (Chala et al 2022 ). Other authors suggest that opportunities exist to develop and implement contextually adapted, structured self-management support training for healthcare providers (Dube et al 2017 ).…”

Exploring mHealth applications for self-management of chronic low back pain: A survey of features and benefits

“…They identified seven factors that affect patient-professional partnerships: communication, mutual understanding, roles of health professionals, information delivery, patients' involvement, individualized care, and healthcare service. Chala et al [85] investigated the perception and conceptualizing of health professionals (medical doctors and physiotherapists) toward self-management for people with CLBP in Ethiopia. They found that self-management is a new concept for many of them, and they lack the competencies to provide self-management support for people with CLBP.…”