title: GP support for self-care: the views of people experiencing long-term back pain.
abstract: BACKGROUND
  Promotion of self-care for persistent back pain and other long-term conditions has become a central component in health care policy in the UK, and general practitioners face increasing demands to support patients' self-care efforts. Gaining insight into patients' views may facilitate support.
  
  
  OBJECTIVE
  To describe patients' experience of self-care for long-term back pain and their views on provision of support for self-care.
  
  
  METHODS
  Adults experiencing persistent back pain were purposively sampled from a community-based survey. In-depth qualitative interviews were audiotaped, transcribed and analysed using the constant comparative method to inductively derive a thematic account of the data.
  
  
  RESULTS
  Most of the 23 interviewees felt a responsibility to self-care. Individual capacity for self-care, however, was variable and could be inhibited by factors such as caring roles or lack of diagnosis and information. GP support for self-care was largely considered to be desirable, although the feasibility of greater provision of support was questioned. Some interviewees expressed a strong preference for alternative models of care and support.
  
  
  CONCLUSIONS
  Self-care for back pain is contextualized by the individual's capacity to self-care and preferences for support. Doubt over the ability of GPs to provide support for self-care may mean that those who have specific needs are reticent to seek help. The role of self-care in the management of back pain should be discussed openly at the consultation level, and GPs may be well placed to signpost patients and provide guidance on the safety of specific self-care activities.
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39, Whatley Road, Bristol, BS8 2PS, UK. fiona.mackichan@bristol.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: MacKichan
authors.forename: Charlotte
authors.initials: C
authors.lastname: Paterson
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000523:psychology / Q000628:therapy*; D059350:Chronic Pain / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D058006:General Practice; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010819:Physician's Role; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*