Abstract
Background: Low back pain (LBP) places a burden on individuals, whānau, and health care systems. Self-management of LBP is critical due to high recurrence rates, and persistent disability. Self-management includes the person’s decision-making ability, health behaviours, and knowing when and where to seek health care support, potentially reducing the burden on people with LBP and health care systems. Little is known about physiotherapists’ attitudes and beliefs towards supporting self-management with people with LBP.
Purpose: We explored New Zealand physiotherapists’ knowledge of self-management concepts, including attitudes and beliefs about supporting self-management with people with LBP.
Methods: Interpretive Description involving semi-structured interviews conducted via Zoom with in-depth data interpretation were conducted.Results: Seventeen physiotherapists, ranging from 24 to 65 years and early graduate to 40+ years of experience, participated. Two defined themes were: (1) Apportioning responsibility; from the belief that an episode of LBP resolves within 12 weeks, participants suggested it was the person’s fault if LBP either persisted or recurred, or something to do with the person’s individual attributes; and (2) Understanding self-management; all participants considered self-management as important, but description of key elements, beyond education and exercises, and strategies to support acquirement of skills by the person with LBP were limited.
Conclusion: Participants had a good understanding about the complexity of LBP yet lacked contemporary knowledge of the natural history of LBP. Participants identified limited key concepts of what self-management entails. Encouraging decision making, behavioural change, problem solving, action planning, and seeking help when required may not be used by NZ physiotherapists to support self-management.
Implications: Physiotherapists should challenge their current biases and beliefs and assimilate more contemporary evidence into their expectations of recovery for LBP. Education and resources about the core components of effective self-management and strategies of how to implement self-management into clinical practice should be encouraged.