Abstract

BackgroundImplementation of best-practice care for patients with low back pain (LBP) is an important issue. Physiotherapists’ who hold unhelpful beliefs are less likely to adhere to guidelines and may negatively influence their patients’ beliefs. Pre-registration education is critical in moving towards a biopsychosocial model of care. This study aimed to investigate the changes in 2nd year physiotherapy students’ beliefs about LBP after a module on spinal pain management and determine whether these changes were maintained at the end of academic training.MethodsDuring three consecutive calendar years, this longitudinal cohort study assessed physiotherapy students’ beliefs with the Back Pain Attitudes Questionnaires (Back-PAQ) in their 1st year, before and after their 2nd year spinal management learning module, and at the end of academic training (3rd year). Unpaired t-tests were conducted to explore changes in Back-PAQ score.ResultsThe mean response rate after the spinal management module was 90% (128/143 students). The mean (± SD) Back-PAQ score was 87.73 (± 14.21) before and 60.79 (± 11.44) after the module, representing a mean difference of − 26.95 (95%CI − 30.09 to − 23.80, p < 0.001). Beliefs were further improved at the end of 3rd year (− 7.16, 95%CI − 10.50 to − 3.81, p < 0.001).ConclusionsA spinal management learning module considerably improved physiotherapy students’ beliefs about back pain. Specifically, unhelpful beliefs about the back being vulnerable and in need of protection were substantially decreased after the module. Improvements were maintained at the end of academic training one-year later. Future research should investigate whether modifying students’ beliefs leads to improved clinical practice in their first years of practice.

Highlights

  • Implementation of best-practice care for patients with low back pain (LBP) is an important issue

  • People commonly believe that the back is vulnerable to injury and needs protection [4,5,6,7,8] and these beliefs may contribute to pain-related fear, catastrophizing and anxiety [9,10,11,12]

  • The response rate and number of students that participated in the study was 90% (95 students) in Bachelor of Science (BSc)-1, 92% (132 students) in BSc-2 before the module, 90% (128 students) in BSc-2 after the module and 87% (80 students) in BSc-3

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Summary

Introduction

Implementation of best-practice care for patients with low back pain (LBP) is an important issue. People commonly believe that the back is vulnerable to injury and needs protection [4,5,6,7,8] and these beliefs may contribute to pain-related fear, catastrophizing and anxiety [9,10,11,12] These psychological factors are important predictors of unhelpful behaviours and elevated levels of disability [13,14,15,16]. While there are many factors that influence implementation of best-practice care, evidence suggests that unhelpful beliefs among health professionals is a significant factor associated with reduced guideline adherence [19,20,21,22]. Addressing health professionals’ unhelpful beliefs has been strongly recommended to improve the quality of care of LBP [11, 17, 18]

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