Trial Title:
Exploring Physiotherapist's Knowledge, Attitudes, Beliefs and Clinical Decision-making Regarding Physical Activity in Chronic Pain Management.
NCT ID:
NCT06605729
Condition:
Cancer Survivorship
Chronic Low Back Pain (CLBP)
Physiotherapy and Rehabilitation
Conditions: Official terms:
Back Pain
Low Back Pain
Conditions: Keywords:
Physiotherapy and rehabilitation
Clinical Decision Making
Attitudes and beliefs
Physical Activity
Chronic Pain
Cancer Survivorship
Knowledge
Chronic Low Back Pain
elearning
Study type:
Interventional
Study phase:
N/A
Overall status:
Recruiting
Study design:
Allocation:
N/A
Intervention model:
Single Group Assignment
Primary purpose:
Health Services Research
Masking:
None (Open Label)
Intervention:
Intervention type:
Other
Intervention name:
e-learning
Description:
The content of this e-learning is based on most recent scientific knowledge and
guidelines about the management of chronic pain and physical activity and on behavioral
change. Four themes are presented: chronic pain, physical activity and chronic pain,
specific populations and behavior change.
Arm group label:
e-learning
Summary:
Chronic pain is a globally increasing problem, with enormous impact on the individual and
society. Within the treatment of chronic pain, physical activity is a key strategy to
improve pain-related complaints. There is ample evidence that physical activity has
numerous benefits and few drawbacks. However, the literature shows that those who
experience chronic pain experience difficulty performing and sustaining physical
activity, and several barriers emerge that hinder physical activity. Patients indicate a
need for the supportive role of the health care provider when it comes to guidance toward
physically active lifestyle. On the other hand, caregivers find it difficult to fill this
role. This can cause frustration for both parties, with a negative impact on the delivery
of care.
Within the treatment of chronic pain, the physiotherapist is an important healthcare
provider. However, it is currently not clear how physiotherapists fulfill their role in
the treatment of a patient with chronic pain. It is also not known what the current
knowledge is among physiotherapists on chronic pain management, what the perceptions and
beliefs around physical activity in the treatment of chronic pain are, and what the
clinical decisions are that they make in the treatment of chronic pain in terms of
physical activity.
To obtain the best and broadest possible answers to these research questions, this study
will examine these themes among physiotherapists with respect to two patient groups;
namely, patients who experience persistent pain after completing their cancer treatment
and individuals with chronic low back pain.
Demographic data such as age, employment, occupational specializations, etc. is gathered.
Furthermore, knowledge of chronic pain, underlying thoughts and perceptions around
chronic pain and physical activity, and clinical decisions of a physiotherapist in
treating a patient with chronic pain, including decisions about physical activity will be
examined.
In addition, this study also investigates whether an elearning around chronic pain and
physical activity, has an effect on these knowledge and treatment actions.
Participants will be asked to complete a set of questionnaires at 2 time points via an
online platform. A first measurement moment happens at the start of the study, after this
the participant gets access to the elearning, the second measurement moment happens 30
days after the first measurement moment.
Detailed description:
Pain is one of the most common, complex and persisting symptoms worldwide. Next to the
debilitating impact on the individual, pain also has a social and economic impact. A
classification of pain based on duration provides the distinction between acute and
chronic pain, with chronic pain described as persistent or recurrent pain for at least 3
months. The chronic pain population consists of patients with a broad variety of medical
conditions. In the literature, a discrimination based on the associated condition is
often made, with the most frequent distinction between non-cancer and cancer-related
pain. Cancer-related pain is a debilitating symptom with a pain prevalence of 39.3% after
curative cancer treatment. Within the non-cancer related pain, spinal pain has the
highest prevalence and low back pain leads the chart of the years with lived disability.
Despite the different underlying condition, physical activity and exercise are the main
part of the best-evidence treatment for chronic pain, both in the population of cancer
survivors with chronic pain as well as in a population of chronic low back pain patients.
It is evident that this effectiveness cannot be attained without a long-term engagement
towards physical activity and exercise behavior. Unfortunately, patient' adherence
towards physical activity is low, which is a problem in most exercise interventions in
the population under study. So, despite the benefits of physical activity for chronic
pain, low physical activity levels are still reported across the span of these two
populations.
Undertaking physical activity is a complex behavior with many aspects that need to be
considered. Knowledge from qualitative studies clarify the self-reported barriers and
facilitators towards physical activity that patients experience. This reveals
similarities between experienced barriers and facilitators in patients from both
populations. At a personal level it is seen that barriers on a physical level such as
pain and barriers and on a psychological level such as low self-efficacy, are similar.
What is also striking is that the health care provider (HCP) also has an important role
to play in physical activity and exercise behavior. Uncertainty, a lack of clear
information is experienced as a barrier and subsequently the need of supervision and
support from an HCP is considered to be a facilitator. Additionally, previous evidence
has already shown the influence of beliefs of HCPs on the beliefs of patients .
The experience of the patient shows that the HCP is part of the key in motivating towards
exercise behavior. Yet, the current research on physical activity and exercise behavior
of patients with chronic pain lacks the perspective of the HCP. It is known that HCPs
with a biomedical view prescribe less active treatment strategies and more advice to rest
in chronic low back pain patients. However, most research on physical activity
prescription behavior stays quite general and therefore, it is not known what exactly
they do or don't prescribe. Next to that, it is unclear what the beliefs and attitudes
are of the HCPs towards physical activity and exercise in chronic pain management and how
that determines this prescription behavior. A group of HCPs who are likely to prescribe
and use exercise in their treatment are physiotherapists. In line with research on other
HCPs, it remains unclear how physiotherapists actually recommend and organize physical
activity for their patients with chronic pain. Additionally, it is not known whether the
manner wherein they prescribe physical activity might differ based on their biomedical or
biopsychosocial orientation, on their beliefs of the associated condition and on the
beliefs on physical activity in relation to chronic pain. This knowledge will help to
understand the physical activity and exercise prescription of physiotherapists and
clarify how this might influence physical activity levels in the patient population of
chronic pain, more specifically chronic low back pain patients and cancer survivors with
chronic pain. The inclusion of these two population-groups, both with varied challenges,
offers an opportunity to increase the generalizability of these findings across chronic
pain conditions and to obtain broad insights into the experiences of people with chronic
pain.
Gaining more insight in the behavior, the beliefs about and attitudes towards physical
activity in physiotherapists who work with chronic pain patients is the first piece of
the puzzle in better supporting patients with chronic pain in their physical activity
journey.
Thereforen, this study has three objectives:
1. To explore the knowledge, the attitudes and beliefs, and the clinical decision
making in chronic pain management, including physical activity as part of this
management of physiotherapists with clinical expertise in:
- chronic low back pain.
- chronic pain in cancer survivorship.
2. To compare the knowledge, the attitudes and beliefs, and the clinical decision
making in chronic pain management between these two groups.
3. To research if an eLearning can change knowledge, the attitudes and beliefs, and the
clinical decision making in chronic pain management, including physical activity as
part of this management of physiotherapists with clinical expertise in:
- chronic low back pain.
- chronic pain in cancer survivorship.
This is a uncontrolled clinical trial study design. Physiotherapists interested in the
study will be invited to connect to the online platform and read the informed consent
about the study.
The study will be conducted through an online survey, consisting of questionnaires and a
clinical case with questions. Following data will be collected through the survey:
1. Demographic data.
2. Knowledge on chronic pain.
3. Implicit and explicit beliefs and attitudes on chronic pain management, including
physical activity as part of pain management.
4. Clinical decision making in chronic pain management, including decisions on physical
activity.
Baseline assessment is completed in one sitting and is estimated to last 30 minutes.
After finishing this first part, they will be invited for an eLearning. The educational
module consists of video-material, implementation exercises and additional literature.
Each participant has an individual login on a protected digital platform from which
content cannot be downloaded or shared, and will be able to access the module for 30
days.
After 30 days, each participant will be asked to repeat the same questionnaires,
regardless if they completed the module or not.
Criteria for eligibility:
Criteria:
Inclusion Criteria:
- To be able to read and write Dutch.
- To have access to a computer with an internet connection.
- Currently working as a physiotherapist in Belgium or the Netherlands.
- Experience with the population at hand.
Exclusion Criteria:
- currently not working as a physiotherapist.
- Other health care professionals.
Gender:
All
Minimum age:
N/A
Maximum age:
N/A
Healthy volunteers:
No
Locations:
Facility:
Name:
University of Antwerp
Address:
City:
Wilrijk
Zip:
2610
Country:
Belgium
Status:
Recruiting
Contact:
Last name:
Sophie Van Dijck, Master of Science
Phone:
+32494843186
Email:
sophie.vandijck@uantwerpen.be
Contact backup:
Email:
sophie.vandijck@uantwerpen.be
Investigator:
Last name:
Sophie Van Dijck, Master of Science
Email:
Sub-Investigator
Start date:
December 15, 2022
Completion date:
July 31, 2025
Lead sponsor:
Agency:
Universiteit Antwerpen
Agency class:
Other
Source:
Universiteit Antwerpen
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT06605729
