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Condon E1, O'Keeffe M2, Critchley D1, White C1
1Kings College London, Physiotherapy, London, United Kingdom, 2Royal Prince Alfred Hospital, School of Public Health, Sydney, Australia
Background: Low back pain (LBP) is a common and costly musculoskeletal disorder, resulting in significant personal, social and economic burden. Attitudes and beliefs of healthcare practitioners (HCPs) are important because they determine the type of treatment and advice offered to patients, and they can influence patients´ attitudes and beliefs about LBP. There is evidence that qualified HCPs can often hold unhelpful beliefs about LBP. Addressing these at undergraduate level might prevent the development of these beliefs, and lead to more evidenced based practitioners. We do not know if these beliefs and attitudes start at the training and student level. Therefore, it is important that we establish what beliefs and attitudes students hold about LBP and determine if they are in line with current clinical practice guidelines. It is important to understand this as it may have implications for future healthcare education and training reform.
Purpose: To examine healthcare students' beliefs and attitudes about LBP.
Methods: A systematic review was conducted of quantitative and qualitative studies. It was reported in accordance with the preferred reporting items PRISMA statement guidelines and was registered on the PROSPERO (CRD42018083477). Studies were included if they were quantitative or qualitative studies that examined healthcare students´ attitudes and beliefs towards LBP. Only studies published in English were included. Eleven electronic databases (Medline, EMBASE, CINAHL, Psych info, AMED, Academic Search Complete, Sport Discus, Biomedical Reference Collection, Psych Articles, Web of Science and Scopus) were searched in February 2018 from the period of inception. Two independent reviewers performed the screening of studies. Methodological quality was assessed using the AXIS appraisal tool by two independent reviewers.
Results: Nine studies were included. All were quantitative studies. Seven countries were included across the studies (Australia, Brazil, Ireland, Scotland, Saudi Arabia, Singapore and Taiwan). The studies included medical, nursing, occupational therapy, pharmacy, chiropractic, and physiotherapy students. The review found strong evidence that healthcare students have more positive beliefs that non-healthcare students. It provided strong evidence that physiotherapy students possess more positive beliefs and attitudes towards LBP than other healthcare disciplines. There is high level evidence that a history/ current LBP does not impact attitudes and beliefs of LBP. There is moderate level evidence that there are differences in attitudes and beliefs cross-culturally. Finally, there were conflicting results found regarding the association of attitudes/ beliefs and treatment orientation/ recommendation. A large limitation of the studies was the failure to provide a cut-off for positive back pain beliefs.
Conclusion(s): Physiotherapy students have better beliefs than other healthcare students. This, however, does not indicate if the beliefs are in a good category. We contend that more detailed questionnaire type studies and/or qualitative studies of students are required to better assess student beliefs. The attitudes and beliefs of healthcare students will affect their attitudes and beliefs post-graduation this in turn could influence treatment recommendations offered to patients.
Implications: Further qualitative research is required to provide an extra dimension to understanding healthcare students´ beliefs and attitudes about LBP. This research may also produce strategies to improve curricula and training to promote a good belief system.
Keywords: Low Back Pain, Attitudes and Beliefs, Healthcare students
Funding acknowledgements: No funding has been received for this research project and there were no conflicts of interest.
Purpose: To examine healthcare students' beliefs and attitudes about LBP.
Methods: A systematic review was conducted of quantitative and qualitative studies. It was reported in accordance with the preferred reporting items PRISMA statement guidelines and was registered on the PROSPERO (CRD42018083477). Studies were included if they were quantitative or qualitative studies that examined healthcare students´ attitudes and beliefs towards LBP. Only studies published in English were included. Eleven electronic databases (Medline, EMBASE, CINAHL, Psych info, AMED, Academic Search Complete, Sport Discus, Biomedical Reference Collection, Psych Articles, Web of Science and Scopus) were searched in February 2018 from the period of inception. Two independent reviewers performed the screening of studies. Methodological quality was assessed using the AXIS appraisal tool by two independent reviewers.
Results: Nine studies were included. All were quantitative studies. Seven countries were included across the studies (Australia, Brazil, Ireland, Scotland, Saudi Arabia, Singapore and Taiwan). The studies included medical, nursing, occupational therapy, pharmacy, chiropractic, and physiotherapy students. The review found strong evidence that healthcare students have more positive beliefs that non-healthcare students. It provided strong evidence that physiotherapy students possess more positive beliefs and attitudes towards LBP than other healthcare disciplines. There is high level evidence that a history/ current LBP does not impact attitudes and beliefs of LBP. There is moderate level evidence that there are differences in attitudes and beliefs cross-culturally. Finally, there were conflicting results found regarding the association of attitudes/ beliefs and treatment orientation/ recommendation. A large limitation of the studies was the failure to provide a cut-off for positive back pain beliefs.
Conclusion(s): Physiotherapy students have better beliefs than other healthcare students. This, however, does not indicate if the beliefs are in a good category. We contend that more detailed questionnaire type studies and/or qualitative studies of students are required to better assess student beliefs. The attitudes and beliefs of healthcare students will affect their attitudes and beliefs post-graduation this in turn could influence treatment recommendations offered to patients.
Implications: Further qualitative research is required to provide an extra dimension to understanding healthcare students´ beliefs and attitudes about LBP. This research may also produce strategies to improve curricula and training to promote a good belief system.
Keywords: Low Back Pain, Attitudes and Beliefs, Healthcare students
Funding acknowledgements: No funding has been received for this research project and there were no conflicts of interest.
Topic: Musculoskeletal: spine
Ethics approval required: No
Institution: Kings College London
Ethics committee: N/A
Reason not required: Ethical Approval was not required for this study
All authors, affiliations and abstracts have been published as submitted.
