Self-management of acute and chronic low back disorders

Q-methodology consists of two parts; 1) a review of the relevant literature and series of discussion groups by patient and healthcare providers to gather accounts related to the topic, and 2) a card-sorting task called Q-sort to capture individual’s personal viewpoints. A total of 60 patients and 60 healthcare providers completed the Q-sort process. The analysis and interpretation of the data was carried out by a team of academic researchers, expert clinicians and patient representatives.

Four different viewpoints emerged:

1. "I can change" - a strong psychological approach, needing a lifestyle/mind-set change. This was the largest viewpoint, expressed mainly by healthcare providers but also shared by some patients.
2. "Some things can change"- a strong pragmatic approach guided by accurate information and practical strategies, shared mostly by patients and some healthcare providers.
3. "Not sure what to / can change"- expressed mostly by patients and few healthcare providers, this concerns the uncertainty in medical diagnosis, with the need for ongoing access to healthcare resources and assistance.
4. "The others need to change"- expressed only by patients, this concerns the social stigma and negative perception of low back pain being in a chronic condition, with reliance on health professionals to acknowledge and validate their problem.

The study findings demonstrate a clear basis to provide better understanding of self-management and encourage effective partnership between patients and healthcare providers. This will help healthcare providers to develop a better approach to how self-management can be utilised with patients on individual basis.

The delivery of the participant-led knowledge translation conference and presenting the findings at local and national conferences have already shown positive impact from both patients and healthcare providers. The findings will add knowledge to the current evidence, which will contribute in future service development and patient education for better and effective management of chronic low back pain.

As part of the project, the research team organised a participant-led knowledge translation conference where all the research participants as well as the local patient and healthcare providers were invited to further discuss the main findings (patient’s and healthcare providers’ viewpoints on self-management in chronic low back pain). The event was structured to encourage the attendees to voice their thoughts during a mixed group discussions on the findings and how this can relate to each individuals (as a patient or a healthcare provider). The discussion and insightful feedback on the viewpoints have provided a strong face validity of the research team’s interpretation of the viewpoints. The attendees’ general feedback on the event was also strongly positive; the majority of the attendees expressed that having participated in a discussion where a mixture of patients and healthcare providers openly discussed the topic “outside their consultation setting” was very beneficial, informative, and educational to really understand the standpoint of the two groups