Is the use of diagnostic imaging and the self-reported clinical management of low back pain patients influenced by the attitudes and beliefs of chiropractors? A survey of chiropractors in the Netherlands and Belgium.

Background: No previous studies have examined the association between attitudes and beliefs of chiropractors and their adherence to low back pain (LBP) guidelines. The aim of this study is: (1) to assess the attitudes and beliefs towards the management of LBP of Dutch and Belgian chiropractors; and...

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Publicado en:Chiropractic & Manual Therapies Vol. 32; no. 1; pp. 1 - 12
Autores principales: van der Vossen, Brenda, de Zoete, Annemarie, Rubinstein, Sidney, Ostelo, Raymond, de Boer, Michiel
Formato: research tables/charts Journal Article
Publicado: BioMed Central 1/8/2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Is the use of diagnostic imaging and the self-reported clinical management of low back pain patients influenced by the attitudes and beliefs of chiropractors? A survey of chiropractors in the Netherlands and Belgium.
      aug:
        au:
          van der Vossen, Brenda
          de Zoete, Annemarie
          Rubinstein, Sidney
          Ostelo, Raymond
          de Boer, Michiel
        affil: Department of Health Sciences, Faculty of Science, VU University Amsterdam, Amsterdam Movement Sciences Research Institute Amsterdam, Amsterdam, The Netherlands
      sug:
        subj:
          Low Back Pain Therapy
          Diagnostic Imaging Utilization
          Self Report
          Self-Management
          Chiropractors Psychosocial Factors
          Professional-Patient Relations
          Attitude of Health Personnel Evaluation
          Health Beliefs Evaluation
          Chiropractors Psychosocial Factors
          Guideline Adherence Evaluation
          Practice Guidelines
          Pain Management Standards
          Low Back Pain Diagnosis
          Human
          Surveys
          Netherlands
          Belgium
          Cross Sectional Studies
          Questionnaires
          Sociodemographic Factors
          Scales
          Latent Structure Analysis
          Linear Regression
          Logistic Regression
          Multiple Regression
          Vignettes
          Comparative Studies
      ab: Background: No previous studies have examined the association between attitudes and beliefs of chiropractors and their adherence to low back pain (LBP) guidelines. The aim of this study is: (1) to assess the attitudes and beliefs towards the management of LBP of Dutch and Belgian chiropractors; and (2) to investigate the association of these attitudes and beliefs on the use of diagnostic imaging and on the adherence to diagnostic guidelines and guidelines in the management of patients with LBP. Methods: Study design: Cross-sectional study using a web-based questionnaire in chiropractic private practices in the Netherlands and Belgium. The survey included sociodemographic characteristics, use of diagnostic imaging, the Pain Attitude and Beliefs Scale-Physiotherapists (PABS.PT) and 6 vignettes (3 acute and 3 chronic LBP patients). We used Latent Profile Analysis (LPA) to categorise the chiropractors into clusters depending on their PABS.PT outcome, whereby the classes differed primarily on the biomedical score. We used linear, logistic, and mixed models to examine the associations between these clusters, and adherence to the recommendations of guidelines on: (1) diagnostic imaging use, and (2) management of LBP (i.e. advice on activity, treatment, return-to-work, and bedrest). Results: The response rate of the Dutch and Belgian chiropractors was 61% (n = 149/245) and 57% (n = 54/95), respectively. The majority of chiropractors scored midrange of the biomedical scale of the PABS.PT. Three clusters were identified using LPA: (1) high biomedical class (n = 18), (2) mid biomedical class (n = 117) and (3) low biomedical class (n = 23). Results from the vignettes suggest that chiropractors in the high biomedical class better adhere to diagnostic imaging guidelines and to LBP guidelines when it concerns advice on return-to-work and activity compared to the other two classes. However, no differences were identified between the classes for treatment of LBP. All chiropractors adhered to the guidelines' recommendation on bedrest. Conclusion: The high biomedical class demonstrated better overall adherence to the practice guidelines for the management of LBP and diagnostic imaging than the other classes. Due to the small numbers for the high and low biomedical classes, these results should be interpreted with caution.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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