Behind the Façade: Understanding Massage Therapists’ Beliefs Towards Low Back Pain and Integrating Movement into Practice - A Mixed Methods Study
Authors List
Ah Kit, R., University of Otago, Christchurch, New Zealand
Lennox Thompson, B., University of Otago, Christchurch, New Zealand
Devan, H., University of Otago, Wellington, New Zealand
Introduction
Low back pain has widespread impact (Buchbinder et al., 2020) and massage therapists play a key role in providing care. Research explores other health practitioners’ beliefs about low back pain (Gardner et al., 2017), but none examine massage therapists’ beliefs or their confidence to use movement in practice – a gap that limits knowledge of how massage therapy contributes to evidence-informed care.
Aims
This thesis explores what massage therapists believe about low back pain, their confidence to use movement in practice, and how they form these beliefs.
Methods
I used an explanatory sequential mixed methods design. An online survey (n=165) measured beliefs using the Pain Attitudes & Beliefs Scale for Physiotherapists (PABS-PT) and confidence to use movement via visual analog scale (0-100). Focus groups (n=13) explored belief formation and movement integration experiences. I analyzed survey data with descriptive and inferential statistics and focus group data using reflexive thematic analysis, integrating both findings.
Findings
Survey participants demonstrated neither strongly biomedical nor strongly biopsychosocial beliefs about low back pain and reported high confidence to integrate movement. Age and training institute predicted biopsychosocial beliefs, while education level predicted movement confidence. I developed five themes from focus group data under the overarching theme: "Behind the façade”. Integration revealed massage therapists move fluidly between biomedical and biopsychosocial perspectives while maintaining person-centred care approaches, and how they conceptualize movement impacts their confidence to use it.
Conclusions
Massage therapists maintain a professional façade of biomedical explanations while delivering fundamentally person-centred care to meet perceived legitimacy requirements. Education should emphasize biopsychosocial approaches and movement integration.
References
Buchbinder, R., Underwood, M., Hartvigsen, J., & Maher, C. G. (2020). The Lancet Series call to action to reduce low value care for low back pain: an update. Pain, 161(Supplement 1), S57-S64. https://doi.org/10.1097/j.pain.0000000000001869
Gardner, T., Refshauge, K., Smith, L., McAuley, J., Hubscher, M., & Goodall, S. (2017). Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies. Journal of Physiotherapy, 63(3), 132-143. https://doi.org/10.1016/j.jphys.2017.05.017
Ah Kit, R., University of Otago, Christchurch, New Zealand
Lennox Thompson, B., University of Otago, Christchurch, New Zealand
Devan, H., University of Otago, Wellington, New Zealand
Introduction
Low back pain has widespread impact (Buchbinder et al., 2020) and massage therapists play a key role in providing care. Research explores other health practitioners’ beliefs about low back pain (Gardner et al., 2017), but none examine massage therapists’ beliefs or their confidence to use movement in practice – a gap that limits knowledge of how massage therapy contributes to evidence-informed care.
Aims
This thesis explores what massage therapists believe about low back pain, their confidence to use movement in practice, and how they form these beliefs.
Methods
I used an explanatory sequential mixed methods design. An online survey (n=165) measured beliefs using the Pain Attitudes & Beliefs Scale for Physiotherapists (PABS-PT) and confidence to use movement via visual analog scale (0-100). Focus groups (n=13) explored belief formation and movement integration experiences. I analyzed survey data with descriptive and inferential statistics and focus group data using reflexive thematic analysis, integrating both findings.
Findings
Survey participants demonstrated neither strongly biomedical nor strongly biopsychosocial beliefs about low back pain and reported high confidence to integrate movement. Age and training institute predicted biopsychosocial beliefs, while education level predicted movement confidence. I developed five themes from focus group data under the overarching theme: "Behind the façade”. Integration revealed massage therapists move fluidly between biomedical and biopsychosocial perspectives while maintaining person-centred care approaches, and how they conceptualize movement impacts their confidence to use it.
Conclusions
Massage therapists maintain a professional façade of biomedical explanations while delivering fundamentally person-centred care to meet perceived legitimacy requirements. Education should emphasize biopsychosocial approaches and movement integration.
References
Buchbinder, R., Underwood, M., Hartvigsen, J., & Maher, C. G. (2020). The Lancet Series call to action to reduce low value care for low back pain: an update. Pain, 161(Supplement 1), S57-S64. https://doi.org/10.1097/j.pain.0000000000001869
Gardner, T., Refshauge, K., Smith, L., McAuley, J., Hubscher, M., & Goodall, S. (2017). Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies. Journal of Physiotherapy, 63(3), 132-143. https://doi.org/10.1016/j.jphys.2017.05.017
