International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 10(9), May, 2018

Pages: 11-14

Date of Publication: 05-May-2018


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Variation in Beliefs Towards Low Back Pain between Physiotherapy and Nursing Students

Author: Deepali Sheth, James Ghagare

Category: Healthcare

Abstract:Variation in beliefs towards low back pain between physiotherapy and nursing students
The objective of this study was to find out the variation in beliefs between physiotherapy and nursing students towards low back pain.
Method: Physiotherapy (n=100) and nursing (n=100) students from various colleges in Pune city completed the survey. Fear Avoidance Beliefs Questionnaire (FABQ) was used. The participants filled up the Fear Avoidance Beliefs Questionnaire.
Result: Student Physiotherapy students had significantly lower Fear Avoidance Beliefs Questionnaire scores (p≤ 0.05) than nursing [CI 95%] students.
Conclusion: Physiotherapy students had less negative beliefs towards low back pain than nursing students.

Keywords: Back pain, Beliefs, Physiotherapy students, Nursing students

Full Text:

Introduction:

Chronic low back pain (LBP) is a serious global public health problem[1]. In fact, it is considered to be the leading cause of absence from work and limitation of activity all over the world [2]. Physicians' attitudes and beliefs regarding low back pain could potentially influence their patients' attitudes and beliefs. Indeed, ample evidence demonstrates that the clinicians' attitudes and beliefs regarding low back pain seem to affect the beliefs of their patients [3‚4].  Physicians' attitudes and beliefs also appeared to influence their recommendations regarding low back pain patients' activities and work [5, 6]. Physiotherapists and nurses also spend a lot of time with patients, so their beliefs can influence the patients' beliefs regarding back pain too.  Given the influence that healthcare practitioners have on a patient's recovery, there has been relatively little study on the attitudes and beliefs held by student healthcare professionals towards low back pain [7]. There has been some investigation into this area which has looked at student nurses and physiotherapists separately [8, 9, 10, 11]. Surprisingly, there is just one study which compares student nurses and physiotherapists[11], it showed that beliefs about the consequences of low back pain and fear avoidance behaviors were more negative in student nurses compared to student physiotherapists.  It is important to know the beliefs of physiotherapists and nurses while they are students so that they can be trained and educated regarding the same as education about back pain does have an effect on the attitudes and beliefs of healthcare students [12]. It is also important to find out whether there is any variation in beliefs towards low back pain between physiotherapy and nursing students which may lead to a difference of opinion and possibly the recovery in patients suffering from low back pain.

Materials and Methods:

Study design: A cross sectional survey was done amongst the physiotherapy and nursing students in Pune city who had completed at least 3rd year in their respective courses.

Procedure: Ethical approval from the institutional ethical committee was taken for this study.  101 physiotherapy and 101 nursing students from different colleges in Pune city participated in this study.  Written consent was taken from each of the participant and they were explained that participation in this study was completely voluntary and that confidentiality would be maintained. They then filled up the Fear Avoidance Beliefs Questionnaire. 

Statistical methods: The data collected was then analyzed using Microsoft Excel and IBM Statistical Program for the Social Sciences (SPSS) version 20.0 (SPSS Inc, Chicago, IL). Average of the Physical Activity subsection and Work Activity subsection of the questionnaire was taken out for both the groups and compared [graph 1]. The scores of both the groups were compared using the Mann Whitney test. A non-parametric 0.95 confidence interval accompanies these estimates as does the ‘p’ value of 0.00 [Tables 1, 2].

Results:

Physiotherapy students had significantly lower Fear Avoidance Beliefs Questionnaire scores than nursing students [p≤ 0.05]. Hence, physiotherapy students have less negative beliefs towards low back pain than nursing students. [graph 1]

Discussion:

The results of this study indicate that student nurses had more negative beliefs about the inevitable consequences of low back pain, as well as displaying more fear-avoidant tendencies about physical activity in their day-to-day lives when compared to their physiotherapy counterparts.  Similar results were found in a study which reported that nursing students had significantly more negative back pain beliefs than physiotherapy students [12]. These differing attitudes and beliefs may be rooted in a number of factors, including level of pain knowledge, as physiotherapy students had a greater knowledge of chronic pain mechanisms when compared to nursing students[7]. Furthermore, this study indicates that the nursing students had significantly more negative beliefs than physiotherapy students regarding the work activity and how it might affect the individual. As more negative beliefs are observed amongst nursing students, finding out the reason for this is important.  Nurses are an integral part of the healthcare team and considering the influence a clinician has on the attitudes and beliefs of patients'‚ it is important to know their beliefs towards low back pain [15, 16].  Different methods have been used to improve the attitudes and beliefs of student healthcare professionals and general population in the past, such as campaigns on back pain [17, 18], teaching modules [19] and information booklets[20].  It has been found previously that a module devoted to low back pain helps improve the attitudes and beliefs of physiotherapy students [19], it can be investigated in the future whether this would also pertain to other healthcare degree students, especially nursing. This might not only improve the perceptions of low back pain amongst nursing students, but also, in turn, be of benefit to patients they manage in the future[7].

Limitations: Generalizability of results is a limitation of this study. Only one city in one country is represented in this study, limiting generalizability.  Confounding factors such as curricula and level of pain knowledge were not accounted for, and factors which can in turn shape the beliefs and attitudes an individual may hold about low back pain[19].

Conclusion: Results from this study show that differences exist in the beliefs of physiotherapy and nursing students toward low back pain. Physiotherapy students had less negative low back pain beliefs while nursing students had more negative beliefs.  This finding highlights the need for education for nurses to promote positive beliefs towards low back pain. Further research is required to provide evidence based recommendations of how to address these contrasting beliefs.

Acknowledgements:

We thank support from Dr. Rachana Dabadghav (Assistant Professor and research coordinator at Sancheti Institute College of Physiotherapy), Dr. Ashok Shyam (MS Ortho) and Dr. Parag Sancheti (Chairman of Sancheti Hospital) for their expert guidance.  The authors wish to acknowledge all the participants of this study for their co-operation, giving us their valuable time and allowing us to conduct this study. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Lastly, I would like to make a special mention for the active technical support by my mother, Prof. Pragna Sheth and my colleague Mr. Deep Shah.

Source of funding: none

Conflict of interest: none

References:

  1. Regina W. S. Sit, Benjamin H. K. Yip, Dicken C. C. Chan, Samuel Y. S. Wong. Primary Care Physicians’ Attitudes and Beliefs towards Chronic Low Back Pain: An Asian Study.  PLOS ONE 2015, DOI:10.1371/journal.pone.0117521

  2. Hoy D, Brooks P, Blyth F, Buchbinder R (2010) The epidemiology of low back pain. Best Practice and Research in Clinical Rheumatology 24:769–781. doi: 10.3928/01913913-20150114-01 PMID: 25608279

  3. Parsons S, Harding G, Breen A, Foster N, Pincus T, et al. (2007) The influence of patients' and primary care practitioners' beliefs and expectations about chronic musculoskeletal pain on the process of care: A systematic review of qualitative studies. Clin J Pain; 23: 91–98. PMID: 17277650

  4. Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, et al.(2012). The association between healthcare professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: A systematic review. European Journal of Pain; 16: 3–17. doi: 10.1016/j. ejpain.2011.06.006 PMID: 21719329

  5. Holden MA, Nicholls EE, Young J, Hay EM, Foster NE(2009) UK-based physical therapists' attitudes and beliefs regarding exercise and knee osteoarthritis: Findings from a mixed-methods study. Arthritis &Rheumatism; 61:1511–12.doi:10.1038/ki.2014.403 PMID: 25608049

  6. Ostelo RW, Stomp-vanden Berg SG, Vlaeyen JW, Wolters PM, deVet HC (2003) Healthcare provider's attitudes and beliefs towards chronic low back pain: The development of a questionnaire. Man Ther; 8: 214–22. PMID:14559044

  7. Norlee Kennedy, John Heasly, Kieran O’Sullivan. The beliefs of third-level health care students towards low back pain. Pain Research and Treatment 2014; 2014, Article ID 675915

  8. P. H. Ferreira, M. L. Ferreira, J. Latimer et al.‚“Attitudes and beliefs of Brazilian and Australian physiotherapy students towards chronic back pain: a cross-cultural comparison‚” Physiotherapy Research International 2004; 9(1):13–23.

  9. S. Poiraudeau, F. Rannou, G. Baron et al.‚“Fear-avoidance beliefs about back pain in patients with subacute low back pain‚” Pain 2006; 124(3):305;11.

  10. T. Mitchell, P. B. O'Sullivan, A. Smith et al.‚“Biopsychosocial factors are associated with low back pain in female nursing students: a cross-sectional study‚” International Journal of Nursing Studies 2009; 46(5);678–88.

  11. C. Ryan, D. Murphy, M. Clark, and A. Lee ‚“The effect of a physiotherapy education compared with a non-healthcare education on the attitudes and beliefs of students towards functioning in individuals with back pain: an observational, cross-sectional study‚” Physiotherapy 2010; 96(2):144–50.

  12. A. Burnett, C. C. Sze, S. M. Tam et al., A cross-cultural study of the back pain beliefs of female undergraduate healthcare students, Clinical Journal of Pain 2009; 25(1):20–28.

  13. Esther Williamson, University of Warwick, UK, Fear Avoidance Beliefs Questionnaire(FABQ). Australian Journal of Physiotherapy 2006; 52.

  14. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993; 52:157-168

  15. R.M.A. Houben, R.W.J. G. Ostelo, J.W.S. Vlaeyen, P. M. J. C. Wolters, M. Peters, and S. G. M. Stomp-van Den Berg‚“Health care providers’ orientations towards common low back pain predict perceived harmfulness of physical activities and recommendations regarding return to normal activity‚” European Journal of Pain 2005; 9(2):173–83.

  16. E. Coudeyre, F. Rannou, F. Tubach et al. ‚“General practitioners’ fear-avoidance beliefs influence their management of patients with low back pain,” Pain 2006; 124(3): 330–337.

  17. D. P. Gross, R. Ferrari, A. S. Russell et al., “A population-based survey of back pain beliefs in Canada,” Spine 2006; 31(18): 2142–2145.

  18. R. Buchbinder, D. Jolley, and M. Wyatt, “Population based intervention to change back pain beliefs and disability: three part evaluation,” British Medical Journal 2001; 332(7301): 1516–1520.

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  20. A. K. Burton, G. Waddell, K. M. Tillotson, and N. Summerton,, “Information and advice to patients with back pain can have a positive effect: a randomized controlled trial of a novel educational booklet in primary care,” Spine 1999; 24(23): 2484–2491.

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Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
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A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
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A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
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A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
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A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
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A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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