Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists.
OBJECTIVE
To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients.


METHODS
Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ (2) tests.


RESULTS
The survey was divided into three subsections; PTs' attitudes on LBP assessment, patients' attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low (< 10%) and 8 statements demonstrated high (> 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a "privilege" which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as "executers", being unable to interfere with treatment plan, possibly implying lack of autonomy.


CONCLUSIONS
Although similarities on history taking methods and on patients' attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.
Evdokia Billis, Charalampos Matzaroglou, Department of Physical Therapy, Technological Educational Institute of Western Greece, 25100 Aigion, Greece.
Evdokia
E
Billis
Evdokia Billis, Charalampos Matzaroglou, Department of Physical Therapy, Technological Educational Institute of Western Greece, 25100 Aigion, Greece.
Christopher J
CJ
McCarthy
Evdokia Billis, Charalampos Matzaroglou, Department of Physical Therapy, Technological Educational Institute of Western Greece, 25100 Aigion, Greece.
John
J
Gliatis
Evdokia Billis, Charalampos Matzaroglou, Department of Physical Therapy, Technological Educational Institute of Western Greece, 25100 Aigion, Greece.
Charalampos
C
Matzaroglou
Evdokia Billis, Charalampos Matzaroglou, Department of Physical Therapy, Technological Educational Institute of Western Greece, 25100 Aigion, Greece.
Jacqueline A
JA
Oldham
Diagnostic practice; Greek; Low back pain; Physiotherapists; United Kingdom
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