%0 Journal Article
%T 'Specialist before physiotherapist': physicians' and physiotherapists' beliefs and management of chronic low back pain in Ghana - A qualitative study.
%A Ampiah JA
%A Moffatt F
%A Diver CJ
%A Ampiah PK
%J Disabil Rehabil
%V 0
%N 0
%D 2024 May 20
%M 38767467
%F 2.439
%R 10.1080/09638288.2024.2356005
%X <B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>Thirty-three individual semi-structured interviews, involving eighteen physio-therapists 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.<BR><B>UNASSIGNED: </B>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).<BR><B>UNASSIGNED: </B>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).<BR>The burden of low back pain is substantial globally, with an increasing burden identified in low-to-middle income countries.This study highlights a predominance of non-evidence-based understandings around chronic low back pain and its management among Ghanaian healthcare professionals, although some evidence-based approaches were also identified.Ghanaian healthcare professionals need to engage with current evidence for chronic low back pain management, incorporate psychological factors and consider non-specific chronic low back pain as a possible diagnostic label.Professional, structural, and sociocultural inclinations towards paternalism, passive therapies, biomedical and fragmented approaches to chronic low back pain management need to be addressed.