Received: 11 October 2021
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Revised: 18 October 2021
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Accepted: 21 October 2021
DOI: 10.1002/msc.1600
RESEARCH ARTICLE
Patients' prior perceptions and expectations of the Enhanced
Transtheoretical Model Intervention for chronic low back
pain: A qualitative study
Ron Feldman
1,2
| Yaniv Nudelman
1,2
| Sharon Haleva‐Amir
3
| Noa Ben Ami
1
1
Department of Physiotherapy, Ariel
University, Ariel, Israel
2
Department of Physiotherapy, ‘Maccabi’
Healthcare Services, Tel‐Aviv, Israel
3
School of Communication, Bar Ilan University,
Ramat‐Gan, Israel
Correspondence
Ron Feldman, Department of Physiotherapy,
Ariel University, Ariel, Israel.
Email: feldmanron5@gmail.com
Abstract
Background: The Enhanced Transtheoretical Model Intervention (ETMI) is an
approach for treating chronic low back pain (CLBP), which demonstrated clinical
and cost‐effectiveness outcomes. ETMI highlights reassurance, return to normal
activities and encouragement of recreational physical activity. In order to optimally
implement ETMI, it is important to gain an understanding of the expectations and
perceptions of patients before they engage with the intervention.
Objectives: To explore CLBP patients' perceptions and expectations of the ETMI
method prior to their first consultation with physiotherapist.
Methods: Qualitative semi‐structured interviews were conducted with 30 CLBP
patients. The interviews were audio‐recorded, transcribed, coded, and analysed
thematically. Patients were first asked about their expectations of treatment, then
they were asked to comment on the ETMI method.
Results: Three main themes emerged from the interviews: (1) Patient's perceptions
of LBP; (2) patient's expectations from current physiotherapy and (3) Patient's ex-
pectations from ETMI method. The patients' perceptions of back pain centred on
biomechanical causal factors, a desire for diagnostic tests and beliefs that rest cures
the pain. Their expectations from current physiotherapy included pain reduction,
passive treatment, a structured exercise program and clear information about LBP.
In reference to the ETMI method, patients expected pain reduction, practical tools
to self‐manage, and a combination of ETMI with passive treatment.
Conclusion: addressing issues around patient's perceptions and expectations of
current physiotherapy and of the ETMI method, prior to their first consultation with
physiotherapist, could be beneficial for understanding how to improve the ETMI
implementation in the health care system.
KEYWORDS
health services research, low back pain, patients expectations, physical therapy
Musculoskeletal Care. 2021;1–12. wileyonlinelibrary.com/journal/msc © 2021 John Wiley & Sons Ltd.
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