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Title: The Role of attitudes and beliefs of health care practitioners in the management of low back pain
Author: Bishop , Annette
ISNI:       0000 0004 2689 0806
Awarding Body: Keele University
Current Institution: Keele University
Date of Award: 2008
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Background. Low back pain (LBP) is a common and frequently recurrent problem, responsible for substantial costs associated with health care utilisation and work absence. Numerous guidelines for the management of non-specific LBP provide broadly similar recommendations. The attitudes and beliefs that health care practitioners (HCPs) hold may be one barrier to the uptake of guideline recommendations. In the UK, most patients seeking healthcare for LBP consult general practitioners (GPs) or physiotherapists (PTs), but there is little research into the attitudes, beliefs and clinical behaviour of these HCPs. Methods. A systematic review was conducted to identify a suitable attitudes and beliefs tool for inclusion in a survey questionnaire. A nationwide cross-sectional survey of GPs and PTs followed. Further studies established the test retest reliability and the smallest detectable change, and explored the factor structure of the chosen attitudes and beliefs measure in UK GPs and PTs. Results. The systematic review identified five tools of which the Pain Attitudes and Beliefs Scale (PABS. PT) was most suitable for inclusion in the questionnaire. The cross-sectional survey showed that the attitudes, beliefs and behaviour of UK HCPs are diverse. There is generally inadequate uptake of guideline recommendations, especially concerning work advice. HCPs' attitudes and beliefs were associated with clinical behaviour. Those with stronger biomedical treatment orientations were less likely to provide guideline consistent advice compared to those with stronger behavioural treatment orientations. The PABS. PT demonstrated satisfactory reliability and the smallest detectable change was calculated. A two-factor structure for the PABS. PT was proposed in both GPs and PTs, which consisted of a robust biomedical factor and a behavioural factor with unsatisfactory internal consistency. Conclusion. The clinical behaviour of GPs and PTs in the UK often diverges from best practice guideline recommendations and the attitudes and beliefs that HCPs hold about LBP are associated with this.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available