Knowledge, attitudes and beliefs on contributing factors among low back pain patients attending outpatient physiotherapy treatment in Malawi.
Nesto Tarimo, Ina Diener
PMID 30135910WHAT IT FOUND
Most Malawian low back pain patients attending physiotherapy had negative beliefs: 93% feared movement and 66.8% held negative attitudes.
Only 8.8% answered all knowledge questions correctly, so ask what patients believe and explain contributing factors.
Key findings
01Most participants held negative attitudes and beliefs about their low back pain; 190 (93%) reported fear of movement and activity avoidance, and 137 (66.8%) demonstrated negative attitudes and beliefs.
02Most participants were only partially knowledgeable about the course and causes of low back pain; 186 (91.2%) were partially knowledgeable and only 18 (8.8%) were fully knowledgeable.
03Most participants believed that all nine Delphi-ranked contributing factors could contribute to the development or worsening of their low back pain; 86.3% agreed on all nine.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used convenience sampling at two hospital outpatient departments in Malawi, so the results may not represent people with low back pain in other settings or people who do not attend physiotherapy. The study was cross-sectional, so it cannot show what caused patients' knowledge, attitudes or beliefs, or whether education changes them. Participants answered self-reported questions, and the paper reports a pilot test for user-friendliness, clarity and completion time, not a test of whether the questionnaire accurately measures knowledge, attitudes or beliefs in this group. The Delphi panel included 15 experienced physiotherapists and used a 70% agreement rule to select nine factors, so the chosen list is based on expert opinion rather than patient outcomes. Some pilot participants found questions unclear because of medical terminology, and the wording was simplified, so responses may still depend on how patients understood the revised items.
The easy way to misread this
Do not read these results as proof that teaching patients about contributing factors improves low back pain. The study only described what patients knew and believed at one time, and it did not test an education intervention.