Experiences, barriers and needs of physiotherapists with regard to providing self-management support to people with low back pain: A qualitative study

Abstract

BackgroundA person-centred, biopsychosocial approach focused on self-management and a healthy lifestyle is recommended for managing non-specific low back pain (LBP). ObjectiveWhat are the experiences of physiotherapists with regard to providing self-management support to people with non-specific LBP? DesignExploratory qualitative. MethodsFourteen 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. ResultsPhysiotherapists 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). ConclusionsPhysiotherapists 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.