Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years
Demoulin, Christophe ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Kinésithérapie spécifique et réadaptation motrice
Roussel, Nathalie ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation
Leysen, Marijke
Van Wilgen, C. Paul
Pitance, Laurent ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation
Reezigt, Roland R.
Voogt, Lennard P.
Dankaerts, Wim
Danneels, Lieven ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation
Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years
Cohen, S.P., Vase, L., Hooten, W.M., Chronic pain: an update on burden, best practices, and new advances. Lancet 397 (2021), 2082–2097, 10.1016/S0140-6736(21)00393-7.
Gatchel, R.J., Peng, Y.B., Peters, M.L., Fuchs, P.N., Turk, D.C., The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull, 133(4), 2007, 581.
Nielsen, M., Keefe, F.J., Bennell, K., Jull, G.A., Physical therapist-delivered cognitive-behavioral therapy: a qualitative study of physical therapists' perceptions and experiences. Phys Ther 94:2 (2014), 197–209, 10.2522/ptj.20130047.
Zangoni, G., Thomson, O.P., ‘I need to do another course’ - Italian physiotherapists' knowledge and beliefs when assessing psychosocial factors in patients presenting with chronic low back pain. Musculoskelet Sci Pract 27 (2017), 71–77, 10.1016/j.msksp.2016.12.015.
Synnott, A., O'Keeffe, M., Bunzli, S., Dankaerts, W., O'Sullivan, P., O'Sullivan, K, Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review. J Physiother 61:2 (2015), 68–76, 10.1016/j.jphys.2015.02.016.
Jeffrey, J.E., Foster, N.E., A qualitative investigation of physical therapists' experiences and feelings of managing patients with nonspecific low back pain. Phys Ther 92:2 (2012), 266–278, 10.2522/ptj.20100416.
Richmond, H., Hall, A.M., Hansen, Z., Williamson, E., Davies, D., Lamb, S.E., Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation. Physiotherapy 104:1 (2018), 107–115, 10.1016/j.physio.2017.03.007.
França, A.A., Dos Santos, V., Lordelo Filho, R., Pires, K.F., Lagoa, K.F., Martins, W.R, ‘It's very complicated’: perspectives and beliefs of newly graduated physiotherapists about the biopsychosocial model for treating people experiencing non-specific low back pain in Brazil. Musculoskelet Sci Pract 42 (2019), 84–89, 10.1016/j.msksp.2019.04.011.
Bevers, K., Watts, L., Kishino, N.D., Gatchel, R.J., The biopsychosocial model of the assessment, prevention, and treatment of chronic pain. US Neurol 12:2 (2016), 98–104, 10.17925/USN.2016.12.02.98.
Gatchel, R.J., Peng, Y.B., Peters, M.L., Fuchs, P.N., Turk, D.C., The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133:4 (2007), 581–624, 10.1037/0033-2909.133.4.581.
Nijs, J., D'Hondt, E., Clarys, P., et al. Lifestyle and chronic pain across the lifespan: an inconvenient truth?. PM R 12:4 (2020), 410–419, 10.1002/pmrj.12244.
Vlaeyen, J.W.S., Crombez, G., Behavioral conceptualization and treatment of chronic pain. Annu Rev Clin Psychol 16 (2020), 187–212, 10.1146/annurev-clinpsy-050718-095744.
Nijs, J., Lahousse, A., Malfliet, A., A paradigm shift from a tissue- and disease-based approach towards multimodal lifestyle interventions for chronic pain: 5 steps to guide clinical reasoning. Braz J Phys Ther, 27(5), 2023, 100556, 10.1016/j.bjpt.2023.100556.
Roitenberg, N., Physiotherapists' attitudes toward low back pain treatment: do work setting and clinical experience with low back patients matter?. J Eval Clin Pract 25:2 (2019), 224–229, 10.1111/jep.13038.
Monaghan, J., Adams, N., Fothergill, M., An evaluation of a pain education programme for physiotherapists in clinical practice. Musculoskelet Care 16:1 (2018), 103–111, 10.1002/msc.1218.
Beneciuk, J.M., George, S.Z., Pragmatic implementation of a stratified primary care model for low back pain management in outpatient physical therapy settings: two-phase, sequential preliminary study. Phys Ther 95:8 (2015), 1120–1134, 10.2522/ptj.20140418.
Webster, B.S., Bauer, A.Z., Choi, Y., Cifuentes, M., Pransky, G.S., Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine 38:22 (2013), 1939–1946, 10.1097/BRS.0b013e3182a42eb6.
Deyo, R.A., Mirza, S.K., Turner, J.A., Martin, B.I., Overtreating chronic back pain: time to back off?. J Am Board Fam Med 22:1 (2009), 62–68, 10.3122/jabfm.2009.01.080102.
Darlow, B., Beliefs about back pain: the confluence of client, clinician and community. Int J Osteopath Med 20 (2016), 53–61.
Christe, G., Nzamba, J., Desarzens, L., Leuba, A., Darlow, B., Pichonnaz, C., Physiotherapists’ attitudes and beliefs about low back pain influence their clinical decisions and advice. Musculoskelet Sci Pract, 53, 2021, 102382, 10.1016/j.msksp.2021.102382.
Gardner, T., Refshauge, K., Smith, L., McAuley, J., Hubscher, M., Goodall, S., Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies. J Physiother 63:3 (2017), 132–143, 10.1016/j.jphys.2017.05.017.
Darlow, B., Fullen, B.M., Dean, S., Hurley, D.A., Baxter, G.D., Dowell, A., 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. Eur J Pain 16:1 (2012), 3–17, 10.1016/j.ejpain.2011.06.006.
Holden, M.A., Nicholls, E.E., Young, J., Hay, E.M., Foster, N.E., UK-based physical therapists' attitudes and beliefs regarding exercise and knee osteoarthritis: findings from a mixed-methods study. Arthrit Rheumat-Arthrit Care Res 61:11 (2009), 1511–1521, 10.1002/art.24829.
Ryan, C., Murphy, D., Clark, M., Lee, A., The effect of a physiotherapy education compared with a non-healthcare education on the attitudes and beliefs of students towards functioning in individuals with back pain: an observational, cross-sectional study. Physiotherapy 96:2 (2010), 144–150, 10.1016/j.physio.2009.09.010.
Bareiss, S.K., Nare, L., McBee, K., Evaluation of pain knowledge and attitudes and beliefs from a pre-licensure physical therapy curriculum and a stand-alone pain elective. BMC Med Educ 19:1 (2019), 1–9.
Domenech, J., Sanchez-Zuriaga, D., Segura-Orti, E., Espejo-Tort, B., Lison, J.F., Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: a randomised clinical trial. Pain 152:11 (2011), 2557–2563, 10.1016/j.pain.2011.07.023.
Springer, S., Gleicher, H., Hababou, H., Attitudes and beliefs about musculoskeletal pain and its association with pain neuroscience knowledge among physiotherapy students in Israel. Isr J Health Policy Res 7:1 (2018), 1–8, 10.1186/s13584-018-0266-4 ARTN 67.
Briggs, E.V., Carr, E.C., Whittaker, M.S., Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom. Eur J Pain 15:8 (2011), 789–795.
Briggs, E.V., Battelli, D., Gordon, D., et al. Current pain education within undergraduate medical studies across Europe: advancing the Provision of Pain Education and Learning (APPEAL) study. BMJ Open, 5(8), 2015, e006984.
Doorenbos, A.Z., Gordon, D.B., Tauben, D., et al. A blueprint of pain curriculum across prelicensure health sciences programs: one NIH Pain Consortium Center of Excellence in Pain Education (CoEPE) experience. J Pain 14:12 (2013), 1533–1538.
Leysen, M., Nijs, J., Van Wilgen, P., et al. Attitudes and beliefs on low back pain in physical therapy education: a cross-sectional study. Braz J Phys Ther 25:3 (2021), 319–328, 10.1016/j.bjpt.2020.08.002.
Buchbinder, R., van Tulder, M., Oberg, B., et al. Low back pain: a call for action. Lancet 391:10137 (2018), 2384–2388, 10.1016/S0140-6736(18)30488-4.
Recommendations by the International Association for the Study of Pain. International Association for the Study of Pain (IASP). Accessed 17/07/2023, https://www.iasp-pain.org/advocacy/iasp-statements/desirable-characteristics-of-national-pain-strategies/.
Buchbinder, R., van Tulder, M., Öberg, B., et al. Low back pain: a call for action. Lancet 391:10137 (2018), 2384–2388, 10.1016/S0140-6736(18)30488-4.
Von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., Gøtzsche, P.C., Vandenbroucke, J.P., The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ 85 (2007), 867–872.
Edwards, A.L., The relationship between the judged desirability of a trait and the probability that the trait will be endorsed. J Appl Psychol, 37(2), 1953, 90.
Houben, R.M.A., Ostelo, R.W.J.G., Vlaeyen, J.W.S., Wolters, P.M.J.C., Peters, M., Stomp-van den Berg SGM. Health care providers' orientations towards common low back pain predict perceived harmfulness of physical activities and recommendations regarding return to normal activity. Eur J Pain 9:2 (2005), 173–183, 10.1016/j.ejpain.2004.05.002.
Ostelo, R.W., Stomp-van den Berg, S.G., Vlaeyen, J.W., Wolters, P.M., de Vet, H.C., Health care provider's attitudes and beliefs towards chronic low back pain: the development of a questionnaire. Man Ther 8:4 (2003), 214–222, 10.1016/s1356-689x(03)00013-4.
Mutsaers, J.H.A.M., Peters, R., Pool-Goudzwaard, A.L., Koes, B.W., Verhagen, A.P., Psychometric properties of the Pain Attitudes and Beliefs Scale for Physiotherapists: a systematic review. Man Ther 17:3 (2012), 213–218, 10.1016/j.math.2011.12.010.
Eland, N.D., Kvåle, A., Ostelo, R.W.J.G., Strand, L.I., Rasch analysis resulted in an improved Norwegian version of the Pain Attitudes and Beliefs Scale(PABS). Scand J Pain 13:1 (2016), 98–108, 10.1016/j.sjpain.2016.06.009.
Rainville, J., Bagnall, D., Phalen, L., Health care providers' attitudes and beliefs about functional impairments and chronic back pain. Clin J Pain 11:4 (1995), 287–295, 10.1097/00002508-199512000-00006.
Houben, R.M., Vlaeyen, J.W., Peters, M., Ostelo, R.W., Wolters, P.M., Stomp-van den Berg SG. Health care providers' attitudes and beliefs towards common low back pain: factor structure and psychometric properties of the HC-PAIRS. Clin J Pain 20:1 (2004), 37–44, 10.1097/00002508-200401000-00008.
Moran, R.W., Rushworth, W.M., Mason, J., Investigation of four self-report instruments (FABT, TSK-HC, Back-PAQ, HC-PAIRS) to measure healthcare practitioners' attitudes and beliefs toward low back pain: reliability, convergent validity and survey of New Zealand osteopaths and manipulative physiotherapists. Musculoskelet Sci Pract 32 (2017), 44–50, 10.1016/j.msksp.2017.08.008.
Rainville, J., Carlson, N., Polatin, P., Gatchel, R.J., Indahl, A., Exploration of physicians' recommendations for activities in chronic low back pain. Spine 25:17 (2000), 2210–2220, 10.1097/00007632-200009010-00012.
Peabody, J.W., Luck, J., Glassman, P., et al. Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med 141:10 (2004), 771–780, 10.7326/0003-4819-141-10-200411160-00008.
Peabody, J.W., Luck, J., Glassman, P., Dresselhaus, T.R., Lee, M., Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA 283:13 (2000), 1715–1722, 10.1001/jama.283.13.1715 Apr 5.
Brunner, E., Probst, M., Meichtry, A., Luomajoki, H., Dankaerts, W., Comparison of clinical vignettes and standardized patients as measures of physiotherapists' activity and work recommendations in patients with non-specific low back pain. Clin Rehabil 30:1 (2016), 85–94, 10.1177/0269215515570499.
Overmeer, T., Boersma, K., Main, C.J., Linton, S.J., Do physical therapists change their beliefs, attitudes, knowledge, skills and behaviour after a biopsychosocially orientated university course?. J Eval Clin Pract 15:4 (2009), 724–732, 10.1111/j.1365-2753.2008.01089.x.
Peabody, J.W., Luck, J., Glassman, P., Dresselhaus, T.R., Lee, M., Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA 283:13 (2000), 1715–1722, 10.1001/jama.283.13.1715.
Monsalves, M.J., Bangdiwala, A.S., Thabane, A., Bangdiwala, S.I., LEVEL (logical explanations & visualizations of estimates in linear mixed models): recommendations for reporting multilevel data and analyses. BMC Med Res Methodol, 20(1), 2020, 3, 10.1186/s12874-019-0876-8.
Scheffer, J., Dealing with missing data, research letters in the information and mathematical sciences. Res Lett Inf Math Sci(3), 2002, 153–160.
Carroll, S.P., Augeard, N., Tennant, J., Seenan, C., How do the attitudes, confidence, knowledge and understanding differ in pre-registration healthcare students towards treating people with chronic pain: an observational, cross-sectional study. Eur J Physiother 23:5 (2021), 311–318, 10.1080/21679169.2020.1746830.
Ferreira, L.S., Silva, MPMe, Saragiotto, B.T., Magalhães, M.O., Attitudes and beliefs of Brazilian physical therapists about chronic nonspecific low back pain and its impact on clinical decision-making: an Online Survey Study. Musculoskelet Sci Pract, 67, 2023, 102832, 10.1016/j.msksp.2023.102832.
Mukoka, G., Olivier, B., Ravat, S., Level of knowledge, attitudes and beliefs towards patients with chronic low back pain among final School of Therapeutic Sciences students at the University of the Witwatersrand – a cross-sectional study. South Afr J Physiother 75:1 (2019), 1–6, 10.4102/sajp.v75i1.683.
Augeard, N., Tennant, J., Carroll, S., Seenan, C., The effect of undergraduate education on pain-related attitudes and beliefs in healthcare students: an observational, cross sectional study. Physiotherapy, 105, 2019, e156.
Linton, S.J., Vlaeyen, J., Ostelo, R., The back pain beliefs of health care providers: are we fear-avoidant?. J Occup Rehabil 12:4 (2002), 223–232, 10.1023/A:1020218422974.
Coudeyre, E., Rannou, F., Tubach, F., et al. General practitioners' fear-avoidance beliefs influence their management of patients with low back pain. Pain 124:3 (2006), 330–337, 10.1016/j.pain.2006.05.003.
Nissen, N., Holm, P.M., Bricca, A., Dideriksen, M., Tang, L.H., Skou, S.T., Clinicians’ beliefs and attitudes to physical activity and exercise therapy as treatment for knee and/or hip osteoarthritis: a scoping review. Osteoarthrit Cartil 30:2 (2022), 260–269.
Thompson, K., Johnson, M.I., Milligan, J., Briggs, M., Twenty-five years of pain education research—what have we learned? Findings from a comprehensive scoping review of research into pre-registration pain education for health professionals. Pain 159:11 (2018), 2146–2158.
Latimer, J., Maher, C., Refshauge, K., The attitudes and beliefs of physiotherapy students to chronic back pain. Clin J Pain 20:1 (2004), 45–50, 10.1097/00002508-200401000-00009.
Bareiss, S.K., Nare, L., McBee, K., Evaluation of pain knowledge and attitudes and beliefs from a pre-licensure physical therapy curriculum and a stand-alone pain elective. BMC Med Educ, 19(1), 2019, 375, 10.1186/s12909-019-1820-7.
Colleary, G., O'Sullivan, K., Griffin, D., Ryan, C.G., Martin, D.J., Effect of pain neurophysiology education on physiotherapy students' understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial. Physiotherapy 103:4 (2017), 423–429, 10.1016/j.physio.2017.01.006.
Mankelow, J., Ryan, C.G., Taylor, P.C., et al. International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students. BMC Med Educ, 22(1), 2022, 547, 10.1186/s12909-022-03488-3.
Mankelow, J., Ryan, C.G., Morris, H., et al. Charting physiotherapy students’ attitudes toward people with chronic pain as they progress through their undergraduate programme: an observational study. Physiother Theory Pract 38:13 (2022), 2658–2664, 10.1080/09593985.2021.1976890.
Mankelow, J., Ryan, C., Taylor, P., Martin, D., The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: a mixed-methods randomised controlled trial. Musculoskelet Sci Pract, 50, 2020, 102249, 10.1016/j.msksp.2020.102249.
Madley-Dowd, P., Hughes, R., Tilling, K., Heron, J., The proportion of missing data should not be used to guide decisions on multiple imputation. J Clin Epidemiol 110 (2019), 63–73.
Eland, N.D., Strand, L.I., Ostelo, R.W., Kvåle, A., Magnussen, L.H., How do physiotherapists understand and interpret the “Pain Attitudes and Beliefs Scale”? A cognitive interview study. Physiother Theory Pract 38:4 (2022), 513–527, 10.1080/09593985.2020.1774949.
Eland, N.D., Kvåle, A., Ostelo, R.W.J.G., de Vet, H.C.W., Strand, L.I., Discriminative validity of the pain attitudes and beliefs scale for physical therapists. Phys Ther 99:3 (2019), 339–353, 10.1093/ptj/pzy139.
Desomer, A., Van WAmbeke, P., Jonckheer, P., Klinische richtlijn rond lage rugpijn en radiculaire pijn. Tijdschr Geneeskd 73:19 (2017), 1182–1195.
Staal J.B., Hendriks E.J.M., Heijmans M., et al. KNGF-richtlijn Lage rugpijn. 2017.
Reezigt, R., Beetsma, A., Koke, A., Hobbelen, H., Reneman, M., Toward consensus on pain-related content in the pre-registration, undergraduate physical therapy curriculum: a Delphi-study. Physiother Theory Pract, 2022, 1–14, 10.1080/09593985.2022.2144562.
Watt-Watson, J., Hunter, J., Pennefather, P., et al. An integrated undergraduate pain curriculum, based on IASP curricula, for six health science faculties. Pain 110:1–2 (2004), 140–148, 10.1016/j.pain.2004.03.019.
Noh, G.-O., Kim, D.H., Effectiveness of a self-directed learning program using blended coaching among nursing students in clinical practice: a quasi-experimental research design. BMC Med Educ 19:1 (2019), 1–8.
Chibnall, J.T., Tait, R.C., Andresen, E.M., Hadler, N.M., Race differences in diagnosis and surgery for occupational low back injuries. Spine 31:11 (2006), 1272–1275, 10.1097/01.brs.0000217584.79528.9b.
Tait, R.C., Chibnall, J.T., Work injury management of refractory low back pain: relations with ethnicity, legal representation and diagnosis. Pain 91:1–2 (2001), 47–56, 10.1016/s0304-3959(00)00418-8.
Christe, G., Pizzolato, V., Meyer, M., Nzamba, J., Pichonnaz, C., Unhelpful beliefs and attitudes about low back pain in the general population: a cross-sectional survey. Musculoskelet Sci Pract, 52, 2021, 102342, 10.1016/j.msksp.2021.102342 ARTN 102342.
Ray, B.M., Kovaleski, A., Kelleran, K.J., et al. An exploration of low back pain beliefs in a Northern America based general population. Musculoskelet Sci Pract, 61, 2022, 102591, 10.1016/j.msksp.2022.102591.
Darlow, B., Perry, M., Stanley, J., et al. Cross-sectional survey of attitudes and beliefs about back pain in New Zealand. BMJ Open, 4(5), 2014, e004725, 10.1136/bmjopen-2013-004725 ARTN e004725.
