A qualitative study of doctors of chiropractic in a Nova Scotian practice-based research network

barriers and facilitators to the screening and management of psychosocial factors for patients with low back pain

Peter Stilwell*, Jill A. Hayden, Piaf Des Rosiers, Katherine Harman, Simon D. French, Janet A. Curran, Warren Hefford

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. Methods: This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. Results: The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. Conclusions: The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers.

Original languageEnglish
Pages (from-to)25-33
Number of pages9
JournalJournal of Manipulative and Physiological Therapeutics
Volume41
Issue number1
DOIs
Publication statusPublished - Jan 2018

Keywords

  • Chiropractic
  • Low Back Pain
  • Psychosocial Factors
  • Qualitative Research

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