Abstract
BackgroundConservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits. Clinicians’ beliefs can affect the advice and education given to patients, in turn, this can influence the uptake of treatment. In New Zealand, most conservative OA management is prescribed by general practitioners (GPs; primary care physicians) and physiotherapists. Few questionnaires have been designed to measure GPs’ and physiotherapists’ osteoarthritis-related health, illness and treatment beliefs. This study aimed to identify if a questionnaire about low back pain beliefs, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), can be adapted to assess GP and physiotherapists’ beliefs about osteoarthritis.MethodsThis study used a cross-sectional observational design. Data were collected anonymously from GPs and physiotherapists using an online survey. The survey included a study-specific demographic and occupational characteristics questionnaire and the PABS-PT questionnaire adapted for osteoarthritis. All data were analysed using descriptive statistics, and the PABS-PT data underwent principal factor analysis.ResultsIn total, 295 clinicians (87 GPs, 208 physiotherapists) participated in this study. The principal factor analysis identified two factors or subscales (categorised as biomedical and behavioural), with a Cronbach’s alpha of 0.84 and 0.44, respectively.ConclusionsThe biomedical subscale of the PABS-PT appears appropriate for adaptation for use in the context of osteoarthritis, but the low internal consistency of the behavioural subscale suggests this subscale is not currently suitable. Future research should consider the inclusion of additional items to the behavioural subscale to improve internal consistency or look to develop a new, osteoarthritis-specific questionnaire.Trial registrationThis trial was part of the primary author’s PhD, which began in 2012 and therefore this study was not registered.
Highlights
IntroductionConservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits
Conservative, first-line treatments for hip and knee joint osteoarthritis are underused despite the known benefits
A large component of the first-line conservative management of osteoarthritis occurs in primary care; in New Zealand, this care is typically provided by physiotherapists and general practitioners (GPs), known elsewhere as primary care physicians [10]
Summary
Conservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits. A large component of the first-line conservative management of osteoarthritis (exercise, education and weight-loss if appropriate) occurs in primary care; in New Zealand, this care is typically provided by physiotherapists and general practitioners (GPs), known elsewhere as primary care physicians [10]. Patients often hold biomechanical or biomedical views of osteoarthritis, driven by a belief that the disease is primarily caused by joint wear and tear [21, 22]. Clinicians’ beliefs and attitudes are known to affect the advice and education they offer their patients, and researchers have suggested that clinicians with biomedical or biomechanical beliefs about osteoarthritis may transfer these beliefs to their patients, affecting their treatment choices [6, 24, 25]. In contrast to patients’ beliefs about osteoarthritis, less is known about clinicians’ beliefs about the disease and its treatment, how clinicians’ beliefs may affect clinical practice, or how to best measure these beliefs [26,27,28,29]
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