To determine whether entry-level education, practice setting, or post-professional training were associated with physical therapists (PTs) attitudes and beliefs regarding LBP management in the United States (US).
An online cross-sectional survey was distributed to PTs in the US between February and March, 2022. The survey consisted of questions about demographics, education and work experience. The Pain Attitudes and Beliefs Scale for Physiotherapists consisting of biomedical (PABS-Bio) and biopsychosocial (PABS-Psy) subscales and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) were administered. Linear regression was used to quantify associations between education, post-professional training, and practice settings with PABS-Bio, PABS-Psy, and HC-PAIRS.
416 PTs responded. The average age was 50.0+/-11.2 years, the majority of the respondents were non-Hispanic or non-Latino (76.9%) and identified as Caucasian/White (87.0%). Compared to respondents with a DPT/tDPT degree, having a Bachelor/Master degree was associated with scoring significantly higher on the PABS-Bio (β=2.5, 95% confidence interval (CI) 0.76–4.3, p=0.005) and HC-PAIRS (β=2.7, 95% CI=0.7–4.6, p=0.006), and lower on the PABS-Psy (β=1.7, 95% CI=-2.7–0.7, p0.001). Those who did not receive post-professional LBP training also scored significantly higher on the PABS-Bio (β=3.7, 95% CI=1.4–6.1, p=0.002) and HC-PAIRS (β=3.9, 95% CI=1.2–6.6, p=0.005). Compared to respondents primarily working in outpatient/wellness settings, respondents whose work settings were acute care/inpatient rehab (β=5.8, 95% CI=1.9–9.8, p=0.004) and home care (β=6.5, 95% CI=1.8-11.2, p=0.006) scored higher on the PABS-Bio. Similar results were found for HC-PAIRS: acute care/inpatient rehab (β=7.3, 95% CI=3.1–11.5, p=0.001), home care (β=5.8, 95% CI=0.7-10.9, p=0.024), and school systems (β=15.5, 95% CI=3.3–27.7, p=0.013). However, those who worked in academic institutions/research centers scored higher on PABS-Psy (β=2.1, 95% CI=0.5–3.7, p=0.023).
Education, post-professional training and work experience were significantly associated with attitudes and beliefs of practicing US PTs regarding LBP management. Those with higher education (i.e., having completed a DPT/tDPT) or additional post-professional training were more likely to endorse a biopsychosocial model. PTs in academic/research settings provided the lowest endorsement for a biomedical model.
These findings suggest areas where educational and professional development programs focused on a biopsychosocial approach to LBP management may help update PT knowledge. The result of such programs could enhance patient care and outcomes.
psychosocial
physical therapy
