title: Exercise prescription for non-specific chronic low back pain (NSCLBP): a qualitative study of patients' experiences of involvement in decision making.
abstract: BACKGROUND
  The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences.
  
  
  OBJECTIVE
  To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan.
  
  
  METHODS
  A qualitative study using a philosophical hermeneutic approach.
  
  
  METHODS
  Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care.
  
  
  RESULTS
  The findings provide a detailed insight into patients' perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients' expectations and patients' needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual.
  
  
  CONCLUSIONS
  Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making.
authors.affiliation: Orthopaedic Assessment Service, Somerset Partnership NHS Foundation Trust, 48 Parkfield Drive, Taunton, Somerset TA1 5BU, UK. Electronic address: robert.stenner@sompar.nhs.uk.
authors.forename: Rob
authors.initials: R
authors.lastname: Stenner
authors.affiliation: Faculty of Health & Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol BS16 1DD, UK. Electronic address: swinkelsannette@gmail.com.
authors.forename: Annette
authors.initials: A
authors.lastname: Swinkels
authors.affiliation: Faculty of Health & Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol BS16 1DD, UK. Electronic address: theresa.mitchell@uwe.ac.uk.
authors.forename: Theresa
authors.initials: T
authors.lastname: Mitchell
authors.affiliation: Faculty of Health & Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol BS16 1DD, UK. Electronic address: shea.palmer@uwe.ac.uk.
authors.forename: Shea
authors.initials: S
authors.lastname: Palmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003657:Decision Making; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D055815:Young Adult
keywords: Back pain; Exercise; Patient-centred care; Shared decision making