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Patients' prior perceptions and expectations of the Enhanced Transtheoretical Model Intervention for chronic low back pain: A qualitative study.

Authors
  • Feldman, Ron1, 2
  • Nudelman, Yaniv1, 2
  • Haleva-Amir, Sharon3
  • Ben Ami, Noa1
  • 1 Department of Physiotherapy, Ariel University, Ariel, Israel. , (Israel)
  • 2 Department of Physiotherapy, 'Maccabi' Healthcare Services, Tel-Aviv, Israel. , (Israel)
  • 3 School of Communication, Bar Ilan University, Ramat-Gan, Israel. , (Israel)
Type
Published Article
Journal
Musculoskeletal care
Publication Date
Jun 01, 2022
Volume
20
Issue
2
Pages
371–382
Identifiers
DOI: 10.1002/msc.1600
PMID: 34726320
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The Enhanced Transtheoretical Model Intervention (ETMI) is an approach for treating chronic low back pain (CLBP), which demonstrated clinical and cost-effectiveness outcomes. ETMI highlights reassurance, return to normal activities and encouragement of recreational physical activity. In order to optimally implement ETMI, it is important to gain an understanding of the expectations and perceptions of patients before they engage with the intervention. To explore CLBP patients' perceptions and expectations of the ETMI method prior to their first consultation with physiotherapist. Qualitative semi-structured interviews were conducted with 30 CLBP patients. The interviews were audio-recorded, transcribed, coded, and analysed thematically. Patients were first asked about their expectations of treatment, then they were asked to comment on the ETMI method. Three main themes emerged from the interviews: (1) Patient's perceptions of LBP; (2) patient's expectations from current physiotherapy and (3) Patient's expectations from ETMI method. The patients' perceptions of back pain centred on biomechanical causal factors, a desire for diagnostic tests and beliefs that rest cures the pain. Their expectations from current physiotherapy included pain reduction, passive treatment, a structured exercise program and clear information about LBP. In reference to the ETMI method, patients expected pain reduction, practical tools to self-manage, and a combination of ETMI with passive treatment. addressing issues around patient's perceptions and expectations of current physiotherapy and of the ETMI method, prior to their first consultation with physiotherapist, could be beneficial for understanding how to improve the ETMI implementation in the health care system. © 2021 John Wiley & Sons Ltd.

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