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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 40, 2024 - Issue 4
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Qualitative Research Reports

Becoming confidently competent: a qualitative investigation of training in cognitive functional therapy for persistent low back pain

, BSc(Hons), PT, , PhD, PTORCID Icon, , PhD, , PhD, PT, , PhD, PT & , PhD, PT
Pages 804-816 | Received 22 Mar 2022, Accepted 20 Nov 2022, Published online: 24 Nov 2022

References

  • Baker R, Camosso‐Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, Robertson N 2010 Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 3: CD005470.
  • Bekkering GE, Hendriks HJ, Koes BW, Oostendorp RA, Ostelo R, Thomassen JM, van Tulder MW 2003 Dutch physiotherapy guidelines for low back pain. Physical Therapy 89: 82–96.
  • Bérubé MÈ, Poitras S, Bastien M, Laliberté LA, Lacharité A, Gross DP 2017 Strategies to translate knowledge related to common musculoskeletal conditions into physiotherapy practice: A systematic review. Physiotherapy 104: 1–8. doi:10.1016/j.physio.2017.05.002.
  • Bhaskar R 2004 The possibility of naturalism: A philosophical critique of the contemporary human sciences. 4th 177–178. London, UK: Routledge.
  • Braun V, Clarke V 2006 Using thematic analysis in psychology. Qualitative Research in Psychology 3: 77–101. doi:10.1191/1478088706qp063oa.
  • Braun V, Clarke V 2019 Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health 11: 589–597. doi:10.1080/2159676X.2019.1628806.
  • Braun V, Clarke V 2021 One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology 18: 328–352. doi:10.1080/14780887.2020.1769238.
  • Caneiro JP, 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: 17–29. doi:10.1016/j.bjpt.2020.06.003.
  • Caneiro JP, Smith A, Rabey M, Moseley GL, O’Sullivan P 2017 Process of change in pain-related fear: Clinical insights from a single case report of persistent back pain managed with cognitive functional therapy. Journal of Orthopaedic and Sports Physical Therapy 47: 637–651. doi:10.2519/jospt.2017.7371.
  • Clarke V, Braun V 2017 Thematic analysis. Journal of Positive Psychology 12: 297–298. doi:10.1080/17439760.2016.1262613.
  • Collins M, Shattell M, Thomas SP 2005 Problematic interviewee behaviors in qualitative research. Western Journal of Nursing Research 27: 188–199. doi:10.1177/0193945904268068.
  • Connelly LM 2016 Trustworthiness in qualitative research. Medsurg Nursing 25: 435–436.
  • Cowell I, O’Sullivan P, O’Sullivan K, Poyton R, McGregor A, Murtagh G 2018 Perceptions of physiotherapists towards the management of non-specific chronic low back pain from a biopsychosocial perspective: A qualitative study. Musculoskeletal Science and Practice 38: 113–119. doi:10.1016/j.msksp.2018.10.006.
  • Cowell I, O’Sullivan P, O’Sullivan K, Poyton R, McGregor A, Murtagh G 2019 The perspectives of physiotherapists on managing nonspecific low back pain following a training programme in cognitive functional therapy: A qualitative study. Musculoskeletal Care 17: 79–90. doi:10.1002/msc.1370.
  • Dagenais S, Caro J, Haldeman S 2008 A systematic review of low back pain cost of illness studies in the United States and internationally. Spine 8: 8–20. doi:10.1016/j.spinee.2007.10.005.
  • Daley BJ, Cervero RM 2016 Learning as the basis for continuing professional education. New Direction in Adult Continued Education 2016: 19–29. doi:10.1002/ace.20192.
  • Denzin NK, Lincoln YS 2017 Introduction. In: Denzin NK, Lincoln YS, Eds The SAGE handbook of qualitative research 5th 1–26. USA: SAGE Publications.
  • Devonshire E, Nicholas MK 2018 Continuing education in pain management: Using a competency framework to guide professional development. Pain Reports 3: e688. doi:10.1097/PR9.0000000000000688.
  • Domenech J, Sanchez-Zuriaga D, Segura-Orti E, Espejo B, Lison JF 2011 Impact of biomedical and biopsychosocial educative modules on the attitudes, beliefs and recommendations of health care providers about low back pain: A randomised clinical trial. Pain 152: 2557–2563. doi:10.1016/j.pain.2011.07.023.
  • Donaghy ME, Morss K 2000 Guided reflection: A framework to facilitate and assess reflective practice within the discipline of physiotherapy. Physiotherapy Theory and Practice 16: 3–14. doi:10.1080/095939800307566.
  • Driver C, Lovell GP, Oprescu F 2020 Psychosocial strategies for physiotherapy: A qualitative examination of physiotherapists’ reported training preferences. Nursing and Health Sciences 23: 136–147. doi:10.1111/nhs.12771.
  • Driver C, Oprescu F, Lovell GP 2020 An exploration of physiotherapists’ perceived benefits and barriers towards using psychosocial strategies in their practice. Musculoskeletal Care 18: 111–121. doi:10.1002/msc.1437.
  • Eva K, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, Sargeant J 2012 Factors influencing responsiveness to feedback: On the interplay between fear, confidence, and reasoning processes. Advances in Health Sciences Education 17: 15–26. doi:10.1007/s10459-011-9290-7.
  • Foster NE, Delitto A 2011 Embedding psychosocial perspectives within clinical management of low back pain: Integration of psychosocially informed management principles into physical therapist practice - Challenges and opportunities. Physical Therapy 91: 790–803. doi:10.2522/ptj.20100326.
  • Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D 2010 Competency-based medical education: Theory to practice. Medical Teacher 32: 638–645. doi:10.3109/0142159X.2010.501190.
  • Fritz J, Söderbäck M, Söderlund A, Sandborgh M 2018 The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice. Physiotherapy Theory and Practice 35: 1182–1193. doi:10.1080/09593985.2018.1476996.
  • Glattacker M, Heyduck K, Meffert C 2012 Illness beliefs, treatment beliefs and information needs as starting points for patient information - Evaluation of an intervention for patients with chronic back pain. Patient Education and Counseling 86: 378–389. doi:10.1016/j.pec.2011.05.028.
  • Gorski PS 2013 What is critical realism? And why should you care? Contemporary Sociology 42: 658–670. doi:10.1177/0094306113499533.
  • Gray LM, Wong-Wylie G, Rempel GR, Cook K 2020 Expanding qualitative research interviewing strategies: Zoom video communications. Qualitative Report 25: 1292–1301.
  • Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE 2012 Knowledge translation of research findings. Implementation Science 7: 50. doi:10.1186/1748-5908-7-50.
  • Gruppen LD, Mangrulkar RS, Kolars JC 2012 The promise of competency-based education in the health professions for improving global health. Human Resources for Health 10: 43. doi:10.1186/1478-4491-10-43.
  • Guerrero AV, Maujean A, Campbell L, Sterling M 2018 A systematic review and meta-analysis of the effectiveness of psychological interventions delivered by physiotherapists on pain, disability and psychological outcomes in musculoskeletal pain conditions. Clinical Journal of Pain 34: 838–857. doi:10.1097/AJP.0000000000000601.
  • Holopainen R, Piirainen A, Karppinen J, Linton SJ, O’Sullivan P 2022 An adventurous learning journey. Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice. Physiotherapy Theory and Practice 38: 309–326. doi:10.1080/09593985.2020.1753271.
  • Holopainen R, Simpson P, Piirainen A, Karppinen J, Schütze R, Smith A, O’Sullivan P, Kent P 2020 Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions: A systematic review and metasynthesis of qualitative studies. Pain 161: 1150–1168. doi:10.1097/j.pain.0000000000001809.
  • Hsu C, Evers S, Balderson BH, Sherman KJ, Foster NE, Estlin K, Levine M, Cherkin D 2019 Adaptation and implementation of the STarT back risk stratification strategy in a US health care organization: A process evaluation. Pain Medicine 20: 1105–1119. doi:10.1093/pm/pny170.
  • Hush JM, Nicholas M, Dean CM 2018 Embedding the IASP pain curriculum into a 3-year pre-licensure physical therapy program: Redesigning pain education for future clinicians. Pain Reports 3: e645. doi:10.1097/PR9.0000000000000645.
  • Jacobs CM, Guildford BJ, Travers W, Davies M, McCracken LM 2016 Brief psychologically informed physiotherapy training is associated with changes in physiotherapists’ attitudes and beliefs towards working with people with chronic pain. British Journal of Pain 10: 38–45. doi:10.1177/2049463715600460.
  • Kallio H, Pietilä AM, Johnson M, Kangasniemi M 2016 Systematic methodological review: Developing a framework for a qualitative semi-structured interview guide. Journal of Advanced Nursing 72: 2954–2965. doi:10.1111/jan.13031.
  • Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM 2004 Psychological aspects of persistent pain: Current state of the science. Journal of Pain 5: 195–211. doi:10.1016/j.jpain.2004.02.576.
  • Kelly JM, Bunzli S, Ritchie C, Kenardy J, Smeets R, Sterling M 2018 Physiotherapist-delivered stress inoculation training for acute whiplash-associated disorders: A qualitative study of perceptions and experiences. Musculoskeletal Science and Practice 38: 30–36. doi:10.1016/j.msksp.2018.09.005.
  • Kent P, O’Sullivan P, Smith A, Haines T, Campbell A, McGregor AH, Hartvigsen J, O’Sullivan K, Vickery A, Caneiro JP, et al. 2019 RESTORE - Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain: Study protocol for a randomised controlled trial. BMJ Open 9: e031133. doi:10.1136/bmjopen-2019-031133.
  • Koes BW, van Tulder M, Lin C, Macedo LG, McAuley J, Maher C 2010 An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal 19: 2075–2094. doi:10.1007/s00586-010-1502-y.
  • Lawford BJ, Delany C, Bennell KL, Bills C, Gale J, Hinman RS 2018 Training physical therapists in person-centered practice for people with osteoarthritis: A qualitative case study. Arthritis Care and Research 70: 558–570. doi:10.1002/acr.23314.
  • Lefroy J, Watling C, Teunissen PW, Brand P 2015 Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. Perspectives on Medical Education 4: 284–299. doi:10.1007/s40037-015-0231-7.
  • Microsoft2018 Skype, https://www.skype.com.
  • Monaghan J, Adams N, Fothergill M 2018 An evaluation of a pain education programme for physiotherapists in clinical practice. Musculoskeletal Care 16: 103–111. doi:10.1002/msc.1218.
  • Nicholas MK, George SZ 2011 Psychologically informed interventions for low back pain: An update for physical therapists. Physical Therapy 91: 765–776. doi:10.2522/ptj.20100278.
  • Nielsen M, Keefe FJ, Bennell K, Jull GA 2014 Physical therapist–delivered cognitive-behavioral therapy: A qualitative study of physical therapists’ perceptions and experiences. Physical Therapy 94: 197–209. doi:10.2522/ptj.20130047.
  • Nijs J, Roussel N, Paul van Wilgen C, Köke A, Smeets R 2013 Thinking beyond muscles and joints: Therapists’ and patients’ attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Manual Therapy 18: 96–102. doi:10.1016/j.math.2012.11.001.
  • O’Sullivan PB, Caneiro JP, O’Keeffe M, Smith A, Dankaerts W, Fersum K, O’Sullivan K 2018 Cognitive functional therapy: An integrated behavioral approach for the targeted management of disabling low back pain. Physical Therapy 98: 408–423. doi:10.1093/ptj/pzy022.
  • O’Sullivan K, O’Sullivan P, O’Sullivan L, Dankaerts W 2013 Back pain beliefs among physiotherapists are more positive after biopsychosocially orientated workshops. Physiotherapy Practice and Research 34: 37–45. doi:10.3233/PPR-2012-0012.
  • Overmeer T, Boersma K, Denison E, Linton SJ 2011 Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? A randomized controlled trial. Physical Therapy 91: 804–819. doi:10.2522/ptj.20100079.
  • Overmeer T, Boersma K, Main CJ, Linton SJ 2009 Do physical therapists change their beliefs, attitudes, knowledge, skills and behaviour after a biopsychosocially orientated university course? Journal of Evaluation in Clinical Practice 15: 724–732. doi:10.1111/j.1365-2753.2008.01089.x.
  • QSR International Pty Ltd. (2019) NVivo Transcription, https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/about/nvivo/modules/transcription
  • Richmond H, Hall AM, Hansen Z, Williamson E, Davies D, Lamb SE 2016 Using mixed methods evaluation to assess the feasibility of online clinical training in evidence based interventions: A case study of cognitive behavioural treatment for low back pain. BMC Medical Education 16: 163. doi:10.1186/s12909-016-0683-4.
  • Rollnick S, Miller WR 1995 What is motivational interviewing? Behavioural and Cognitive Psychotherapy 23: 325–334. doi:10.1017/S135246580001643X.
  • Sandborgh M, Asenlof P, Lindberg P, Denison E 2010 Implementing behavioural medicine in physiotherapy treatment. Part II: Adherence to treatment protocol. Advances in Physiotherapy 12: 13–23. doi:10.3109/14038190903480672.
  • Sanders T, Ong B, Sowden G, Foster N 2014 Implementing change in physiotherapy: Professions, contexts and interventions. Journal of Health Organization and Management 28: 96–114. doi:10.1108/JHOM-10-2011-0102.
  • Simpson P, Holopainen R, Schütze R, O’Sullivan P, Smith A, Linton SJ, Nicholas M, Kent P 2021 Training of physical therapists to deliver individualized biopsychosocial interventions to treat musculoskeletal pain conditions: A scoping review. Physical Therapy 101: zab188. doi:10.1093/ptj/pzab188.
  • Stevenson K, Lewis M, Hay E 2006 Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? Journal of Evaluation in Clinical Practice 12: 365–375. doi:10.1111/j.1365-2753.2006.00565.x.
  • Synnott A, O’Keeffe M, Bunzli S, Dankaerts W, O’Sullivan P, O’Sullivan K 2015 Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: A systematic review. Journal of Physiotherapy 61: 68–76. doi:10.1016/j.jphys.2015.02.016.
  • Synnott A, O’Keeffe M, Bunzli S, Dankaerts W, O’Sullivan P, Robinson K, O’Sullivan K 2016 Physiotherapists report improved understanding of and attitude toward the cognitive, psychological and social dimensions of chronic low back pain after Cognitive Functional Therapy training: A qualitative study. Journal of Physiotherapy 62: 215–221. doi:10.1016/j.jphys.2016.08.002.
  • Tebes JK 2005 Community science, philosophy of science, and the practice of research. American Journal of Community Psychology 35: 213–230. doi:10.1007/s10464-005-3399-x.
  • Ten Cate O, Billett S 2014 Competency‐based medical education: Origins, perspectives and potentialities. Medical Education 48: 325–332. doi:10.1111/medu.12355.
  • Tong A, Sainsbury P, Craig J 2007 Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 19: 349–357. doi:10.1093/intqhc/mzm042.
  • van der Wees PJ, Jamtvedt G, Rebbeck T, de Bie RA, Dekker J, Hendriks EJ 2008 Multifaceted strategies may increase implementation of physiotherapy clinical guidelines: A systematic review. Journal of Physiotherapy 54: 233–241.
  • Vibe Fersum K, O’Sullivan P, Skouen JS, Smith A, Kvåle A 2013 Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: A randomized controlled trial. European Journal of Pain 17: 916–928. doi:10.1002/j.1532-2149.2012.00252.x.
  • Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, Charlson F, Davis A, Degenhardt L, Dicker D, et al. 2015 Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the global burden of disease study 2013. Lancet 386: 743–800.
  • VERBI Software. (2020) MAXQDA 2020, maxqda.com
  • Webster-Wright A 2009 Reframing professional development through understanding authentic professional learning. Review of Educational Research 79: 702–739. doi:10.3102/0034654308330970.
  • Winstone NE, Nash RA, Parker M, Rowntree J 2017 Supporting learners’ agentic engagement with feedback: A systematic review and a taxonomy of recipience processes. Educational Psychologist 52: 17–37. doi:10.1080/00461520.2016.1207538.
  • Zangoni G, Thomson OP 2017 ‘I need to do another course’ - Italian physiotherapists’ knowledge and beliefs when assessing psychosocial factors in patients presenting with chronic low back pain. Musculoskeletal Science and Practice 27: 71–77. doi:10.1016/j.msksp.2016.12.015.

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