title: Experiences of Rehabilitation Professionals with the Implementation of a Back School for Patients with Chronic Low Back Pain: A Qualitative Study.
abstract: A standardized curriculum back school (CBS) has been recommended for further dissemination in medical rehabilitation in Germany. However, implementation of self-management education programs into practice is challenging. In low back pain care, individual factors of professionals could be decisive regarding implementation fidelity. The study aim was to explore attitudes and experiences of professionals who conducted the back school. Qualitative interviews were led with 45 rehabilitation professionals. The data were examined using thematic analysis. Three central themes were identified: (a) "back school as a common thread," (b) "theory versus practice," and (c) "participation and patient-centeredness." The CBS and its manual were frequently described positively because they provide structure. However, specified time was mentioned critically and there were heterogeneous perceptions regarding flexibility in conducting the CBS. Theory and practice in the CBS were discussed concerning amount, distribution, and conjunction. Participation and patient-centeredness were mainly mentioned in terms of amount and heterogeneity of participation as well as the demand for competences of professionals. Factors were detected that may either positively or negatively influence the implementation fidelity of self-management education programs. The results are explorative and provide potential explanatory mechanisms for behavior and acceptance of rehabilitation professionals regarding the implementation of biopsychosocial back schools.
authors.affiliation: Department of Medical Psychology, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstraße 3, 97070 Würzburg, Germany.
authors.forename: Stefan
authors.identifier: 0000-0003-0780-9016
authors.initials: S
authors.lastname: Peters
authors.affiliation: Department of Medical Psychology, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstraße 3, 97070 Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.affiliation: Institute of Sport Science and Sport, Chair of Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany.
authors.forename: Klaus
authors.identifier: 0000-0003-2418-373X
authors.initials: K
authors.lastname: Pfeifer
authors.affiliation: Department of Medical Psychology, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstraße 3, 97070 Würzburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Meng