Biomedical Beliefs Explain the Clinical Decisions Made by Exercise-Based Practitioners for People With Chronic Low Back Pain
| Autor: | Mitchell T. Gibbs, Paul W. M Marshall, Natalie M.V. Morrison |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Biopsychosocial model Attitude of Health Personnel MEDLINE 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Humans Medicine Orthopedics and Sports Medicine Exercise Accreditation 030222 orthopedics business.industry Background data Australia Middle Aged humanities Chronic low back pain Physical Therapists Clinical Practice Conservative treatment Cross-Sectional Studies Scale (social sciences) Female Neurology (clinical) business Low Back Pain human activities 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Spine. 46:114-121 |
| ISSN: | 1528-1159 0362-2436 |
| DOI: | 10.1097/brs.0000000000003698 |
| Popis: | Study design Cross-sectional survey. Objective This study surveyed the attitudes and beliefs of physiotherapists and accredited exercise physiologists (AEP) toward chronic low back pain (CLBP), in Australia. The objective of this study was to investigate the effect of biomedical and biopsychosocial attitudes and beliefs toward CLBP on clinical decision making in exercise-based practitioners. Summary of background data The attitudes and beliefs of AEPs toward CLBP have not been studied. Literature regarding physiotherapists suggests a biomedical approach leading to more conservative treatment and on occasion, treatment going against practice guidelines. Methods Seventy five AEPs and 75 physiotherapists were surveyed using the pain attitudes and beliefs scale for physiotherapists, which consists of both a biomedical and biopsychosocial subscale. Clinical decision making was assessed using two patient vignettes. Results AEPs held higher biomedical beliefs compared with physiotherapists. No between-group differences were observed on the biopsychosocial subscale. Indeed, biomedical attitudes and beliefs did explain clinical decision making with higher scores reflecting a more conservative approach. However, biomedical beliefs influenced decision making regardless of profession. Conclusion Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP.Level of Evidence: 3. |
| Databáze: | OpenAIRE |
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