Experiences, barriers and needs of physiotherapists with regard to providing self-management support to people with low back pain: A qualitative study
Charlotte van den Heuvel, Jorn van der Horst, Eva Winkelhorst, Eefje G.J. Roelofsen, Nathan Hutting
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.