Background & Aims
Musculoskeletal pain, resulting from multifactorial interactions among psychological, structural, social, and lifestyle factors, is best understood and addressed through the biopsychosocial model (Lewis et al., 2018; Caneiro et al., 2021). In this context, self-management, behavioral changes, and the development of self-efficacy are fundamental elements to optimize outcomes and sustain benefits acquired during rehabilitation (Farzad et al., 2021; Chester et al., 2019; Lewis et al., 2021). However, uncertainties exist regarding the alignment of physiotherapeutic clinical practice in Brazil with the scientific recommendations of this approach. Thus, this study aimed to diagnose the theoretical knowledge and clinical practices of physiotherapists working in the musculoskeletal field concerning strategies for promoting self-efficacy and self-management. The goal is to provide insights for future educational interventions.
Methods
This cross-sectional study employed an online questionnaire to collect data from physiotherapists working in the musculoskeletal field in Brazil. The questionnaire addressed knowledge, clinical practice, and the promotion of self-efficacy and self-management strategies. Sociodemographic information, educational background, professional profile (years of practice, article reading habits, possession of postgraduate degrees), and work sector (private, public, or both) were also gathered. Descriptive analysis of categorical data is presented in frequencies (percentages).
Results
347 physiotherapists (69% female, average age 32 years) participated, predominantly with a Lato Sensu degree(73.5%) and lacking a Stricto Sensu background(75%). About 44% had <5 years of experience, primarily practicing in the private healthcare system (71%). Physiotherapists emphasized the importance of self-efficacy assessment (98%), usually using simple questions (92%) over structured questionnaires. Among those promoting self-efficacy (96%), 44% used specific strategies, mainly verbal persuasion(79%). Challenges included doubts about ideal strategies, patient beliefs, adherence, communication, and knowledge on the subject. 83% had a low frequency of reading about the theme. 95% prescribed home exercises and conducted follow-ups during clinical appointments (91%). Common self-management support strategies were advising (91%), agreeing upon (80%), assisting (73%), and assessing (63%). 79% faced challenges in self-management, involving adherence, ideal strategies, and patient beliefs.
Conclusions
This study demonstrates that although the assessment, promotion of self-efficacy, and self-management are valued and carried out by physiotherapists, their complete implementation as an intervention strategy appears to face significant obstacles that could be overcome with a systematic and intentional approach.
References
Caneiro, J. P.; Bunzli, S.; O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Brazilian Journal of Physical Therapy, 25(1), 17–29.
Lewis, J.; O’Sullivan, P. (2018). Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? British Journal of Sports Medicine, 52(24), 1543–1544.
Farzad, M.; Macdermid, J. C.; Ring, D. C.; Shafiee, E. (2021). A Scoping Review of the Evidence regarding Assessment and Management of Psychological Features of Shoulder Pain. Rehabilitation Research and Practice, 2021, 7211201.
Chester, R.; Khondoker, M.; Shepstone, L.; Lewis, J. S.; Jerosch-Herold, C. (2019). Self-efficacy and risk of persistent shoulder pain: Results of a Classification and Regression Tree (CART) analysis. British Journal of Sports Medicine, 53(13), 825–834.
Lewis, J.; Ridehalgh, C.; Moore, A.; Hall, K. (2021). This is the day your life must surely change: Prioritising behavioural change in musculoskeletal practice. Physiotherapy, 112, 158–162.
Presenting Author
Carolina Matiello Souza
Poster Authors
Topics
- Assessment and Diagnosis