Aim: What are the experiences of musculoskeletal clinicians in delivering reassurance to patients with non-specific low back pain in primary care?
Method: We conducted a qualitative study of musculoskeletal clinicians (physiotherapists n=16, and chiropractors n=16) who manage low back pain in primary care. We recruited participants until an acceptable breadth and depth of data was achieved. Clinicians participated in semi-structured interviews about their experiences delivering reassurance. The interview schedule was developed using the Theoretical Domains Framework and analysed using framework thematic analysis.
Results: Four themes were identified: 1) Giving reassurance: a core clinical skill for delivering high-quality care; 2) It takes practice and experience to confidently deliver reassurance; 3) Despite feeling capable and motivated, clinicians identified situations that make it more challenging to deliver reassurance; and 4) Reassurance needs to be contextualised to the individual. Clinicians found it more challenging to deliver reassurance in situations where: patients were less likely to experience a favourable prognosis; there were difficulties in establishing rapport; or if patients had previous poor experiences with back pain. Clinicians stressed the importance of delivering individualised reassurance by addressing patient-specific concerns and worries.
Conclusion: Musculoskeletal clinicians possess a strong understanding of reassurance but require clinical experience to confidently deliver it. We reflect on these clinical insights and provide recommendations for how best to deliver tailored educational messages and safe movement experiences to successfully reassure patients with back pain.