title: Patients' perspectives on self-management following a back rehabilitation programme.
abstract: OBJECTIVE
  The management of chronic low back pain (CLBP) is becoming increasingly demanding upon health care services and society. Programmes combining exercise, education and a biopsychosocial approach have become a popular way of managing CLBP. Programmes are designed to change behaviour, increase activity levels and encourage self-management. Patients' experiences of attending a back rehabilitation programme were examined.
  
  
  METHODS
  This study used a qualitative approach combining interviews, non-participant observation and evaluation of documentation to establish the patients' perspective of self-management following a back programme.
  
  
  RESULTS
  All the patients (n = 6 ) indicated they were self-managing by continuing to exercise and utilizing the advice given after attendance. Two patients felt they should continue attending the therapy department to exercise in order to gain benefit, demonstrating reliance on continued health care support. Obstacles to continuing with exercise were cited as pain, time, and family constraints. Patients also expressed limitations following attendance regarding the type and level of activity their CLBP would allow them to manage. The data suggested activity limitation was inadvertently reinforced by the therapists during the sessions, in the programme letter and by the patients' existing beliefs regarding the cause of their CLBP.
  
  
  CONCLUSIONS
  The study demonstrated the importance of understanding patients' beliefs and expectations prior to a back programme and accounting for these during attendance. This study also highlighted that all heath care professionals should be aware of the impact of the language and terminology used when working with CLBP patients.
authors.affiliation: Physiotherapy Department, Haywood Hospital, Stoke-on-Trent, Staffs.
authors.forename: Alison Louise
authors.initials: AL
authors.lastname: Morris