The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: A systematic review

European Journal of Pain - Tập 16 Số 1 - Trang 3-17 - 2012
Ben Darlow1,2, Brona M. Fullen3, Sarah Dean4, Deirdre A. Hurley3, G. David Baxter1, Anthony Dowell2
1Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin 9054, New Zealand
2Department of Primary Health Care and General Practice University of Otago Wellington PO Box 7343, Wellington South 6242 New Zealand
3School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
4Peninsula College of Medicine and Dentistry Universities of Exeter and Plymouth Exeter EX2 4SG United Kingdom

Tóm tắt

AbstractBackground

It has been suggested that health care professional (HCP) attitudes and beliefs may negatively influence the beliefs of patients with low back pain (LBP), but this has not been systematically reviewed. This review aimed to investigate the association between HCP attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of this patient population.

Methods

Electronic databases were systematically searched for all types of studies. Studies were selected by predefined inclusion criteria. Methodological quality was appraised and strength of evidence was determined.

Results

Seventeen studies from eight countries which investigated the attitudes and beliefs of general practitioners, physiotherapists, chiropractors, rheumatologists, orthopaedic surgeons and other paramedical therapists were included. There is strong evidence that HCP beliefs about back pain are associated with the beliefs of their patients. There is moderate evidence that HCPs with a biomedical orientation or elevated fear avoidance beliefs are more likely to advise patients to limit work and physical activities, and are less likely to adhere to treatment guidelines. There is moderate evidence that HCP attitudes and beliefs are associated with patient education and bed rest recommendations. There is moderate evidence that HCP fear avoidance beliefs are associated with reported sick leave prescription and that a biomedical orientation is not associated with the number of sickness certificates issued for LBP. Conclusion: HCPs need to be aware of the association between their attitudes and beliefs and the attitudes and beliefs and clinical management of their patients with LBP.

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European Journal of Pain

Tập 16 Số 1

3-17

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