Illness beliefs regarding low back pain in patients and health care professionals
The first part of this thesis focusses on the illness perceptions of the patient. First, we wanted to systematically review the clinimetric properties of the IPQ-R and the Brief IPQ, 2 questionnaires to measure a patient’s illness perceptions. Given the focus of the present thesis, we limited the search to patients with musculoskeletal disorders. The results show that the IPQ-R is an appropriate instrument to explore illness beliefs in patients with musculoskeletal disorders. The clinimetric properties of the Brief IPQ are poor. Therefore, it should be used with caution in quantitative research, but still has its value in qualitative research or in clinical practice if combined with an elaborate interview. Secondly, we aimed at exploring the added value of illness perceptions in explaining functional disability and habitual physical activity in patients with chronic low back pain. The results show that functional disability is closely related to illness perceptions in patients with chronic low back pain, independent from established psychological correlates, such as fear of movement, depression and pain catastrophizing. However, in the present study, illness perceptions failed to explain the variance in habitual physical activity levels in chronic low back pain patients. The second part of this thesis focusses on the attitudes and beliefs of health care practitioners. In chapter 4 it is shown that guideline adherence for low back pain is very low among 2nd and 4th grade physical therapy students in Belgium and the Netherlands, where 4th grade students show more biopsychosocial beliefs and provide more guideline adherent recommendations than 2nd grade students. It is demonstrated that biomedical beliefs are associated with poor adherence to evidence based guidelines. Our results show no relationship between a personal history of low back pain and one’s beliefs or attitudes. The last chapter explores the beliefs and guideline adherent attitudes in low back pain among physical therapists in Belgium. The results show that guideline adherence among physical therapists in Belgium is low and related to the therapist’s beliefs concerning low back pain. Physical therapists with a longer time since graduation tend to display a stronger biomedical view compared to those with less time since graduation. This doctoral thesis paves the way to look into proper guideline adherence strategies in educational programmes and at national level, to enhance efficiency and reduce medical costs for low back pain, as to build a well-developed quality-control system for physical therapists in Belgium.
Antwerpen : Universiteit Antwerpen & Vrije Universiteit Brussel , 2023
156 p.
Supervisor: Roussel, Nathalie [Supervisor]
Supervisor: Nijs, Jo [Supervisor]
Supervisor: Wilgen, Van, Paul [Supervisor]
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Creation 17.10.2023
Last edited 27.10.2023
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