Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

Physiother Theory Pract. 2018 Oct;34(10):795-805. doi: 10.1080/09593985.2018.1425785. Epub 2018 Jan 18.

Abstract

Introduction: Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice.

Method: A cross-sectional observational survey.

Results: The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score.

Conclusion: Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

Keywords: Beliefs and attitudes; chronic low back pain; goal setting; physiotherapists.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology
  • Chronic Pain / therapy*
  • Cross-Sectional Studies
  • Delivery of Health Care* / trends
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / physiopathology
  • Low Back Pain / psychology
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Motivation
  • Pain Measurement
  • Patient Care Planning* / trends
  • Patient Participation
  • Physical Therapists / psychology*
  • Physical Therapists / trends
  • Physical Therapy Modalities* / trends
  • Self Care
  • Treatment Outcome
  • Young Adult