Self-management support for people with non-specific low back pain: A qualitative survey among physiotherapists and exercise therapists

Hutting, Nathan; Oswald, Wiebke; Staal, J. Bart; Heerkens, Yvonne

doi:10.1016/j.msksp.2020.102269

Cited by 26 publications

(16 citation statements)

References 27 publications

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“…The SM support should prepare people to manage health conditions effectively and maintain quality of life. The preparatory programme should thus prepare and empower patients towards SM of their chronic MSKP disorders, and support them during the process (Cooper, Smith & Hancock 2009 ; Hutting et al 2020 ; Peek et al 2016 ). Psychological adjustment in resilience and preparedness to take responsibility may lead to favourable outcomes.…”

Section: Support Programmes To Prepare Individuals With Persistent Musculoskeletal Pain For Self-managementmentioning

confidence: 99%

“…Physiotherapists are in a good position to empower patients towards SM of MSKP, and are frequently considered as part of the rehabilitation team (Hutting et al 2020 ; Soderlund et al 2020 ). Results from some successful outcomes in studies on the management of persistent MSKP have informed us on what kind of therapy or therapist is needed in the support programme, for SM to be successful (Foster & Delitto 2011 ).…”

Section: What Is Likely Needed For Successful Self-management Of a Musculoskeletal Pain Disorder?mentioning

confidence: 99%

“…Healthcare providers therefore need to have knowledge of the current evidence-base of care for persistent pain (Lin et al 2020 ; Parker & Madden 2020 ). Also, they should strive to follow researched requirements to implement a successful SM support programme and facilitate adherence to the programme (Hutting et al 2020 ; Peek et al 2016 :127–135). A holistic patient-centred approach by the healthcare provider is one comprised of the three roles of: educator, partner and coach (Solvang & Fougner 2016 :591–602), suggesting that changing to SM, needs education of the patient in a strong therapeutic relationship, and awareness of the living conditions of the patient.…”

Section: What Is Likely Needed For Successful Self-management Of a Musculoskeletal Pain Disorder?mentioning

confidence: 99%

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Physiotherapy support for self-management of persisting musculoskeletal pain disorders

Diener

2021

South African Journal of Physiotherapy

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Section: Support Programmes To Prepare Individuals With Persistent Musculoskeletal Pain For Self-managementmentioning

confidence: 99%

Section: What Is Likely Needed For Successful Self-management Of a Musculoskeletal Pain Disorder?mentioning

confidence: 99%

Section: What Is Likely Needed For Successful Self-management Of a Musculoskeletal Pain Disorder?mentioning

confidence: 99%

See 1 more Smart Citation

Physiotherapy support for self-management of persisting musculoskeletal pain disorders

Diener

2021

South African Journal of Physiotherapy

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“…Previous literature from other regions also indicated that the term self-management is ambiguous that lacks clarity and is open to interpretation [ 21 , 32 , 56 ]. Evidence shows that self-care and self-treatment have been used in association or as a surrogate term with self-management [ 57 – 59 ]. However, these concepts vary in their aims, nature of interventions, and the level of patient engagement in the process [ 35 , 60 ].…”

Section: Discussionmentioning

confidence: 99%

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

Chala

Miller

Ghahari

et al. 2022

BMC Health Serv Res

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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.

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“…Physiotherapists have reported a lack of confidence to apply psychosocial strategies in their practice (Driver, Lovell, & Oprescu, 2019) and barely include psychosocially oriented illness perceptions in history taking (Roussel et al., 2016). In line with this, a qualitative survey indicated that self‐management support provided to patients by physiotherapists are affected by a lack of tools and mainly related to biomechanical factors (Hutting et al., 2020). Patients, however, want integration of psychosocial perspectives (Chou et al., 2018).…”

Section: Introductionmentioning

confidence: 97%

Building therapeutic alliances with patients in treatment for low back pain: A focus group study

Unsgaard-Tøndel

Söderström

2021

Physiotherapy Res Intl

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Background and Purpose Low back pain is a multidimensional disorder and a biopsychosocial management approach is recommended. However, recent data indicates that physiotherapists mainly focus on biomechanical aspects in treatment and struggle with addressing psychosocial barriers for recovery. We wanted to explore how physiotherapists express their experiences of building therapeutic alliances within a biopsychosocial perspective of low back pain. Methods Qualitative focus‐group interviews were performed with five physiotherapists on two occasions with 6 months in between. Data were analyzed within a hermeneutical perspective with decontextualization and recontextualization, and identification of themes. Results Four main themes were identified from the analyses: (1) An ideal standard: Presence, empathy and applying the biopsychosocial perspective is central for building therapeutic alliance. (2) Time‐consuming: Active listening and personally adapted treatment is important and time‐consuming. (3) Challenging area: Advanced clinical reasoning is needed to understand and modify complex barriers for recovery. Clinical experience is sometimes necessary to integrate the psychological and social domains into physiotherapy management. (4) The art of balancing: Important to apply sensitive communication to help patients gain new insight. Some heavy psychosocial demands on patients may be outside physiotherapists' professional competence. Discussion The physiotherapists in this focus group study expressed a shared view that therapeutic alliance should build upon person‐centering, motivational communication, and facilitation of lifestyle adjustments within a biopsychosocial perspective of low back pain. Complex clinical reasoning necessary as the optimal cause‐corrective treatment strategies were often not obvious. Time and tools to uncover and modify relevant psychological obstacles for recovery were perceived challenging and partly dependent on clinical experience. Addressment of psychosocial obstacles for recovery should be included in basic as well as postgraduate curriculums for physiotherapists. Collaborative practice support strategies like peer guidance and better platforms for interprofessional collaboration and decision support could contribute to improve practice in the psychosocial domain.

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Self-management support for people with non-specific low back pain: A qualitative survey among physiotherapists and exercise therapists

Cited by 26 publications

References 27 publications

Physiotherapy support for self-management of persisting musculoskeletal pain disorders

Physiotherapy support for self-management of persisting musculoskeletal pain disorders

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

Building therapeutic alliances with patients in treatment for low back pain: A focus group study

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