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General practitioners' recommendations of self-directed-exercises for musculoskeletal problems and perceived barriers and facilitators to doing so : a mixed methods study
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Gillman, Toby, Schmidtke, Kelly, Manning, Victoria and Vlaev, Ivo (2018) General practitioners' recommendations of self-directed-exercises for musculoskeletal problems and perceived barriers and facilitators to doing so : a mixed methods study. BMC Health Services Research, 18 . 998. doi:10.1186/s12913-018-3799-x ISSN 1472-6963.
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Official URL: https://doi.org/10.1186/s12913-018-3799-x
Abstract
Background: Musculoskeletal problems substantially impact the demand for and the finances of the United Kingdom’s National Health Service. Some of this demand and cost could be alleviated if patients use self-directed-exercises. The present study aims first to establish whether general practitioners already recommend self-directed-exercises and second to describe barriers and facilitators to making such recommendations. Method: The design of the current study included surveys and interviews. The surveys were designed to draw out participants’ tendency to recommend self-directed-exercises and their behavioral drivers to do so. The drivers investigated include 14 domains described by the Theoretical Domains Framework. The surveys were completed online and the responses were analyzed using descriptive reports and regression analyses. The interviews were designed to more fully understand participants’ experiences recommending self-directed-exercises according to the same framework. The interviews were audio-taped, transcribed, and thematically analyzed. Results: The survey found that the following domains significantly predicted participants’ tendency to recommend self-directed-exercises: Environmental contexts and resources, Goals, Intentions, Knowledge, Memory attention and decision processes, and Social/professional role. The interviews brought out four themes that could be leveraged to increase general practitioners’ tendency to recommend self-directed-exercises: (1) Practitioners’ beliefs about self-directed exercises being effective, (2) Patients’ motivations to engage in self-directed-exercises, (3) Time constraints, and (4) The ease with which practitioners can recommend self-directed-exercises. Conclusions: Most general practitioners already recommend self-directed-exercises, though they note significant barriers that may prevent them from doing so. General practitioners’ tendency to recommend self-directed-exercises would be bolstered by creating a respected central resource of exercise pamphlets. These pamphlets should clearly describe how different self-directed-exercises should be performed and evidence supporting their effectiveness. Trial registration: The current study was not considered a trial by the local research and development department. Instead it was considered a service evaluation that did not require ethical approval/registry.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Social Sciences > Warwick Business School > Behavioural Science Faculty of Social Sciences > Warwick Business School |
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Library of Congress Subject Headings (LCSH): | Musculoskeletal system -- Diseases, Musculoskeletal system -- Diseases -- Alternative treatment, Exercise , Self-care, Health | ||||||
Journal or Publication Title: | BMC Health Services Research | ||||||
Publisher: | Biomed central | ||||||
ISSN: | 1472-6963 | ||||||
Official Date: | 27 December 2018 | ||||||
Dates: |
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Volume: | 18 | ||||||
Article Number: | 998 | ||||||
DOI: | 10.1186/s12913-018-3799-x | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 17 December 2018 | ||||||
Date of first compliant Open Access: | 2 January 2019 | ||||||
RIOXX Funder/Project Grant: |
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