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Characterization of physiotherapists practice and perceptions regarding patient education of patients with chronic low back pain
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Advisor(s)
Abstract(s)
Enquadramento: A dor lombar crónica é das causas principais de anos vividos com
incapacidade. As guidelines recomendam a utilização de um modelo biopsicossocial para
a avaliação e intervenção nesta condição, com recurso a abordagens activas, onde a
educação sobre a dor assume especial relevância. A literatura existente tem demonstrado
que a prática clíncia neste âmbito é heterogénea, não só entre países mas entre os
profissionais de cada país, o que pode comprometer os resultados clínicos obtidos.
Adicionalmente, pouco é conhecido sobre a diferença, na implementação desta
modalidade terapêutica, entre fisioterapeutas recém-formados e com mais anos de
experiência.
Objetivo: Este estudo teve como objectivo investigar a percepção e uso da educação,
enquanto modalidade de terapêutica no tratamento de utentes com dor lombar crónica,
pelos fisioterapeutas em Portugal. Teve também o objectivo de investigar a influência da
experiência dos fisioterapeutas, procurando diferenças entre a prática auto-reportada de
educação e os anos de experiência no tratamento de indivíduos com dor lombar crónica.
Metodologia: Realizou-se um estudo transversal, com recurso a um questionário online
onde os fisioterapeutas portugueses auto-reportaram a sua prática clínica no que diz
respeito à educação de utentes com dor lombar crónica. Numa segunda fase, os dados
recolhidos foram divididos em 2 grupos: recém-formados (5 ou menos de 5 anos de
experiência) e experientes (6 ou mais anos de experiência).
Resultados: 112 fisioterapeutas reportaram formas distintas de implementar a educação
no contexto da dor lombar crónica, a maioria não seguindo consistentemente as
guidelines. Verificou-se uma diferença entre a prática de profissionais recém formados e
com mais anos de experiência, onde os primeiros reportaram menor uso de abordagens
educativas centradas no utente. Os fisioterapeutas com menos experiência identificaram
mais barreiras à educação, especialmente barreiras relacionadas com características dos
utentes.
Conclusões: Este estudo constituíu um contributo para a investigação sobre a percepção
e caracterização da educação, enquanto modalidade terapêutica utilizada pelos
fisioterapeutas portugueses no tratamento de indivíduos com dor lombar crónica. Os
resultados apontam para uma divergência entre a prática clínica em Portugal e as
recomendações internacionais para abordagem da dor lombar crónica e chamam a atenção
para diferenças importantes na atuação dos fisioterapeutas em função do número de anos
de experiência profissional.
Background: Chronic low back pain is one of the leading causes of years lived with disability. Clinical guidelines have recommended the use of a biopsychosocial model to assess and address chronic low back pain, with a focus on active approaches, where patient education plays a role of the utmost importance. The existing literature has indicated heterogeneous approaches to chronic low back pain, not only between countries, but amidst one’s country, and this diversity may compromise the clinical outcomes. Additionally, little is known about the implementation of patient education among novice and non-novice physiotherapists. Objective: This study aimed to investigate the perception and use of patient education, by physiotherapists in Portugal, in the context of chronic low back pain. It also aimed to investigate the influence of physiotherapists` experience on self-reported patient education practice, looking for differences between the self-reported practice of patient education and physiotherapists` years of experience working with individuals with chronic low back pain. Methods: A transversal study was carried out based on an online questionnaire where Portuguese physiotherapists self-reported their practice regarding patient education in the scope of chronic low back pain. The data were divided in 2 groups: novices (5 or less years of experience) and non-novices (6 or more years of experience). Results: 112 physiotherapists reported quite distinct ways of managing chronic low back pain, most not consistent with guidelines regarding patient education. There were differences between the practice of novice and non-novice physiotherapists, whith the former reporting less use of patient-centred approaches to education. Novice physiotherapists reported more barriers to patient education, especially those related to patient`s characteristics. Conclusions: This study contributed to research on the Portuguese physiotherapists` perceptions and characterization of clinical practice in the scope of patient education of patients with chronic low back pain. Results showed a divergency between the participants` clinical practice and the international guidelines for management of chronic low back pain, and highlighted important differences in the physioterapists’ approaches, according to their years of experience
Background: Chronic low back pain is one of the leading causes of years lived with disability. Clinical guidelines have recommended the use of a biopsychosocial model to assess and address chronic low back pain, with a focus on active approaches, where patient education plays a role of the utmost importance. The existing literature has indicated heterogeneous approaches to chronic low back pain, not only between countries, but amidst one’s country, and this diversity may compromise the clinical outcomes. Additionally, little is known about the implementation of patient education among novice and non-novice physiotherapists. Objective: This study aimed to investigate the perception and use of patient education, by physiotherapists in Portugal, in the context of chronic low back pain. It also aimed to investigate the influence of physiotherapists` experience on self-reported patient education practice, looking for differences between the self-reported practice of patient education and physiotherapists` years of experience working with individuals with chronic low back pain. Methods: A transversal study was carried out based on an online questionnaire where Portuguese physiotherapists self-reported their practice regarding patient education in the scope of chronic low back pain. The data were divided in 2 groups: novices (5 or less years of experience) and non-novices (6 or more years of experience). Results: 112 physiotherapists reported quite distinct ways of managing chronic low back pain, most not consistent with guidelines regarding patient education. There were differences between the practice of novice and non-novice physiotherapists, whith the former reporting less use of patient-centred approaches to education. Novice physiotherapists reported more barriers to patient education, especially those related to patient`s characteristics. Conclusions: This study contributed to research on the Portuguese physiotherapists` perceptions and characterization of clinical practice in the scope of patient education of patients with chronic low back pain. Results showed a divergency between the participants` clinical practice and the international guidelines for management of chronic low back pain, and highlighted important differences in the physioterapists’ approaches, according to their years of experience
Description
Keywords
Dor Lombar Crónica Educação Fisioterapeutas Recém-formados e Experientes Chronic low back pain Patient education Novice and Non-Novice Physiotherapists