The advice given by physiotherapists to people with back pain in primary care
The advice given by physiotherapists to people with back pain in primary care
Background: back pain guidelines endorse giving advice to enable people to self-manage and continue normal activities. Little is known however, about the content of advice that clinicians give and this project aimed to identify the advice given by clinicians to patients with back pain at their initial consultation.
Methods: a secondary analysis was conducted with 25 audio-recordings and transcriptions of consultations between patients with back pain and physiotherapists in a primary care outpatients department. Using a Framework approach, the data were coded and analysed to identify the content of advice given and mode of delivery.
Results: the mean duration of consultation was 38 min 59 s (range 26:21–53:16). Advice was given in 88% (n = 22/25) of consultations and 96% included additional exercise instruction. Cognitive reassurance was evident, focussing on getting people confident to ‘move your back’ despite pain and encouraging active lifestyle changes. Beyond reassurance and discussion to enhance confidence, the key topics of advice given were: activity promotion; postural changes; practical self-help advice regarding ways to sit; pain-management advice including medication and using heat. Gaps were identified in the advice given, most notably there was a lack of specificity relating to the frequency and duration of recommended tasks and activities.
Conclusions: advice and reassurance are integral to enabling people to self-manage their back pain. It is important to avoid contradictory and unhelpful messages. Despite its importance, little is known about the advice offered by clinicians during initial back pain consultations highlighting the need for guidance to be patient-centred and tailored.
Advice, Low back pain, Physical therapy, Reassurance, Self-management
Osborn-Jenkins, Lisa
6d67e394-41f9-4313-8312-e8b840351354
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
1 October 2021
Osborn-Jenkins, Lisa
6d67e394-41f9-4313-8312-e8b840351354
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
Osborn-Jenkins, Lisa and Roberts, Lisa
(2021)
The advice given by physiotherapists to people with back pain in primary care.
Musculoskeletal Science and Practice, 55, [102403].
(doi:10.1016/j.msksp.2021.102403).
Abstract
Background: back pain guidelines endorse giving advice to enable people to self-manage and continue normal activities. Little is known however, about the content of advice that clinicians give and this project aimed to identify the advice given by clinicians to patients with back pain at their initial consultation.
Methods: a secondary analysis was conducted with 25 audio-recordings and transcriptions of consultations between patients with back pain and physiotherapists in a primary care outpatients department. Using a Framework approach, the data were coded and analysed to identify the content of advice given and mode of delivery.
Results: the mean duration of consultation was 38 min 59 s (range 26:21–53:16). Advice was given in 88% (n = 22/25) of consultations and 96% included additional exercise instruction. Cognitive reassurance was evident, focussing on getting people confident to ‘move your back’ despite pain and encouraging active lifestyle changes. Beyond reassurance and discussion to enhance confidence, the key topics of advice given were: activity promotion; postural changes; practical self-help advice regarding ways to sit; pain-management advice including medication and using heat. Gaps were identified in the advice given, most notably there was a lack of specificity relating to the frequency and duration of recommended tasks and activities.
Conclusions: advice and reassurance are integral to enabling people to self-manage their back pain. It is important to avoid contradictory and unhelpful messages. Despite its importance, little is known about the advice offered by clinicians during initial back pain consultations highlighting the need for guidance to be patient-centred and tailored.
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The advise given by physiotherapists ...
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Accepted/In Press date: 22 May 2021
e-pub ahead of print date: 29 May 2021
Published date: 1 October 2021
Additional Information:
Funding Information:
The research time and preparation of the manuscript was funded by the NIHR as part of a funded Pre-Doctoral Clinical Academic Fellowship (PCAF) awarded to Lisa Osborn-Jenkins and undertaken at the University of Southampton . The NIHR had no involvement in the preparation of the article for publication or the study design, data collection, analysis or write up of the study report.
Funding Information:
No specific funding was sought for this cross-sectional observation study however the senior researcher Professor Lisa Roberts was funded by a National Institute for Health Research ( NIHR ) Senior Clinical Lectureship (round 3); and Arthritis Research UK funded the original data collection [grant number 17830 ].
Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Advice, Low back pain, Physical therapy, Reassurance, Self-management
Identifiers
Local EPrints ID: 453457
URI: http://eprints.soton.ac.uk/id/eprint/453457
ISSN: 2468-7812
PURE UUID: 9e655a7e-9c30-4fd3-83d6-63b7a34f5373
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Date deposited: 18 Jan 2022 17:32
Last modified: 17 Mar 2024 06:44
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Author:
Lisa Osborn-Jenkins
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