‘Specialist before physiotherapist’: physicians’ and physiotherapists’ beliefs and management of chronic low back pain in Ghana – A qualitative study

Ampiah, Josephine Ahenkorah; Moffatt, Fiona; Diver, Claire J.; Ampiah, Paapa Kwesi; Diver, Claire J

Abstract

Purpose: This study provides an understanding of the chronic low back pain (CLBP) beliefs and management practices of physicians/doctors and physiotherapists in Ghana, and the mechanisms underlying their beliefs and practices. Materials/Methods: Thirty-three individual semi-structured interviews, involving eighteen physio­therapists and fifteen physicians involved with CLBP management, were carried out. Interviews were audio recorded, transcribed, and analysed using Straussian grounded theory principles and critical realist philosophy. Results: Five categories were derived: The predominance of bio-medical/mechanical beliefs, maladaptive beliefs, maladaptive practices, limited involvement of physiotherapists and other healthcare professionals (HCPs) and evidence-based beliefs and practices. The predominant mechanisms underlying the HCPs beliefs and practices were: the healthcare environment (professional roles/identity hinged around paternalistic and biomedical care, fragmented CLBP management, limited physiotherapy/HCPs’ knowledge) and sociocultural environment (sociocultural/patients’ expectations of passive therapy and paternalism). Conclusion: The CLBP beliefs and practices of HCPs involved with CLBP in Ghana is modelled around a professional identity that is largely hinged on paternalism and bio-medical/mechanical understandings. Lack of collaboration and sociocultural expectations also play a significant role. There is the need for a reconstitution of Ghanaian HCPs’ CLBP beliefs and management approaches to align with evidenced-based approaches (e.g., imaging should not be universally prescribed, biopsychosocial and patient-centred care).

Citation

Ampiah, J. A., Moffatt, F., Diver, C. J., Ampiah, P. K., & Diver, C. J. (2024). ‘Specialist before physiotherapist’: physicians’ and physiotherapists’ beliefs and management of chronic low back pain in Ghana – A qualitative study. Disability and Rehabilitation, 1-11. https://doi.org/10.1080/09638288.2024.2356005

• Journal Article Type: Article
• Acceptance Date: May 13, 2024
• Online Publication Date: May 20, 2024
• Publication Date: Jan 1, 2024
• Deposit Date: Aug 12, 2024
• Publicly Available Date: Aug 13, 2024
• Journal: Disability and Rehabilitation
• Electronic ISSN: 0963-8288
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Pages: 1-11
• DOI: https://doi.org/10.1080/09638288.2024.2356005
• Keywords: Africa, healthcare professionals, Ghana, Chronic low back pain, management, beliefs, doctors, physiotherapists
• Public URL: https://nottingham-repository.worktribe.com/output/35712388
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/09638288.2024.2356005#abstract
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=idre20; Received: 2023-10-04; Accepted: 2024-05-13; Published: 2024-05-20