The Perspectives of physiotherapists on managing non-specific low back pain following a training programme in Cognitive Functional Therapy: a qualitative study
File(s)Post-training qualy _21.08.18.docx (167.02 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Background: It has long been acknowledged that nonspecific chronic low back pain (NSCLBP) is associated with a complex combination of biopsychosocial (BPS) factors, and recent guidelines advocate that the management of back pain should reflect this multidimensional complexity. Cognitive functional therapy (CFT) is a behaviourally oriented intervention that targets patients' individual BPS profiles. Although the efficacy of CFT has been demonstrated in primary care, little evidence exists about the training requirements of this approach.
Methods: Qualitative semistructured interviews were conducted with 10 physiotherapists working in primary care, who had undergone a formal training programme in CFT. A purposive sampling method was employed to seek the broadest perspectives. Thematic analysis was used to analyse the interview transcripts and capture the emergent themes.
Results: Five main themes emerged: (i) the learning challenge; (ii) self‐reported changes in confidence; (iii) self‐reported changes in communication practice; (iv) self‐reported changes in attitudes and understanding; (v) the physiotherapists felt that CFT was more effective than their usual approach for NSCLBP but identified barriers to successful implementation, which included a lack of time and difficulties in engaging patients with strong biomedical beliefs.
Conclusions: The study suggested that training in CFT has the capacity to produce self‐reported changes in physiotherapists' attitudes, confidence and practice. The provision of such training has implications in terms of time and costs; however, this this may be warranted, given the physiotherapists' strong allegiance to the approach compared with their usual practice.
Methods: Qualitative semistructured interviews were conducted with 10 physiotherapists working in primary care, who had undergone a formal training programme in CFT. A purposive sampling method was employed to seek the broadest perspectives. Thematic analysis was used to analyse the interview transcripts and capture the emergent themes.
Results: Five main themes emerged: (i) the learning challenge; (ii) self‐reported changes in confidence; (iii) self‐reported changes in communication practice; (iv) self‐reported changes in attitudes and understanding; (v) the physiotherapists felt that CFT was more effective than their usual approach for NSCLBP but identified barriers to successful implementation, which included a lack of time and difficulties in engaging patients with strong biomedical beliefs.
Conclusions: The study suggested that training in CFT has the capacity to produce self‐reported changes in physiotherapists' attitudes, confidence and practice. The provision of such training has implications in terms of time and costs; however, this this may be warranted, given the physiotherapists' strong allegiance to the approach compared with their usual practice.
Date Issued
2019-03-01
Date Acceptance
2018-10-05
Citation
Musculoskeletal Care, 2019, 17 (1), pp.79-90
ISSN
1478-2189
Publisher
Wiley
Start Page
79
End Page
90
Journal / Book Title
Musculoskeletal Care
Volume
17
Issue
1
Copyright Statement
© 2018 John Wiley & Sons, Ltd. This is the pre-peer reviewed version of the article, which has been published in final form at https://dx.doi.org/10.1002/msc.1370.
Sponsor
Private Physiotherapy Educational Foundation
Grant Number
N/A
Subjects
Science & Technology
Life Sciences & Biomedicine
Rheumatology
low back pain
physiotherapy
qualitative research
PSYCHOSOCIAL FACTORS
BELIEFS
COMMUNICATION
KNOWLEDGE
ATTITUDES
CLASSIFICATION
INTERVENTIONS
MANAGEMENT
PEOPLE
MODELS
low back pain
physiotherapy
qualitative research
Adult
Clinical Competence
Cognitive Behavioral Therapy
Female
Health Knowledge, Attitudes, Practice
Humans
London
Low Back Pain
Male
Physical Therapists
Qualitative Research
Humans
Low Back Pain
Health Knowledge, Attitudes, Practice
Qualitative Research
Clinical Competence
Adult
London
Female
Male
Physical Therapists
Cognitive Behavioral Therapy
Arthritis & Rheumatology
1110 Nursing
Publication Status
Published
Date Publish Online
2018-11-23