Knowledge of psychosocial factors associated with low back pain amongst health science students: a scoping review

Abstract

BackgroundLow back pain is a burden worldwide and biological, psychological, and social mechanisms play a role in its development and persistence. Current guidelines support care using the biopsychosocial model. However, biomedical constructs dominate clinician training, and it is unknown the extent to which health science students understand the psychosocial determinates of a patient’s low back pain. Therefore, the aim of this scoping review is to report health science students’ current knowledge of psychosocial factors associated with low back pain.MethodsA scoping review framework was used to search electronic databases for research examining health science students’ knowledge of psychosocial factors associated with low back pain. The nature and findings of the studies are highlighted using the data charting tool. Each study was analyzed to determine the type of outcome measurement used. Scores were compared to minimum accepted scores, between disciplines, as education advanced, and after educational modules.ResultsFourteen studies published between 2004 and 2019 were identified. Seven healthcare disciplines were represented.In total, 12 different measurement tools were utilized. In 9 studies students demonstrated inadequate knowledge of psychosocial factors associated with low back pain. Three tools compared disciplines and nationalities. Three tools were associated with practice behavior. Eight studies showed improvement as students’ education advanced, and 3 studies demonstrated improvements in knowledge after implementation of pain education modules of varied lengths. Of those, two showed significant improvement.ConclusionsHealth science students in these studies had substandard understanding of psychosocial factors associated with low back pain. Dedicated pain education has the potential to improve low back pain understanding, resulting in more guideline appropriate care recommendation.

The attitudes and beliefs of physiotherapists, family physicians and physiatrists concerning chronic low back pain

“…The authors concluded that physicians and nurses had a stronger belief that low back pain causes disability and activity limitation than physiotherapists and occupational therapists. In another study (27) evaluating the attitudes and beliefs of senior students in physiotherapy and rehabilitation, medicine, and nursing using BBQ, physiotherapy (28) reported that physiotherapy and rehabilitation students had more positive beliefs than those studying in the remaining disciplines. In the current study, we observed more pessimistic beliefs concerning CLBP among the family physicians compared to the physiotherapists, and among the physiotherapists compared to the physiatrists based on the BBQ scores.…”

The prevalence of psychosocial related terminology in chiropractic program courses, chiropractic accreditation standards, and chiropractic examining board testing content in the United States

“…There is a significant translational gap between knowledge of the contribution of psychosocial factors to SRDs and implementation in the training of all healthcare disciplines, including chiropractic. To point, a recent scoping review found substandard awareness amongst all health science students (e.g., chiropractic, physical therapy, medical) with respect to psychosocial factors and low back pain [ 8 ]. Without tangible changes at the educational level, this gap is unlikely to narrow.…”

“…Despite these guidelines, adoption of the BPS model in chiropractic care settings is arguably incomplete [ 6 , 7 ]. Furthermore, students across various healthcare disciplines, including chiropractic, have a poor awareness of these psychosocial factors [ 8 ].…”

Healthcare students’ attitudes towards patient centred care: a systematic review with meta-analysis

“…An electronic database search strategy was developed with a health sciences librarian and searches were conducted in MEDLINE, EMBASE, CINAHL from inception until March 1, 2021, with no language restriction. The search strategy and search terms were informed by previous reviews on patient centred care [ 12 ] and healthcare students [ 13 ]. Our search strategy combined terms relating to ‘patient centred care’, ‘attitudes’, and ‘healthcare students’ and was designed to capture studies investigating healthcare students attitudes towards patient centred care as per our preregistered protocol.…”