Advanced Back Rehab Class (ABC): Is there value in adding education?

Purpose

Explore Guy´s and St Thomas´ patient preference for educational content and delivery to improve provision of care for those referred to the advanced back class.

 

63%
of patients felt like they understand their back pain 'very well'.
55%
of patients felt like they were 'very confident' in managing back pain themselves.
62%
off patients wanted more information about back pain.


45%
of patients preferred electronic delivery of information.

Approach

A brief literature search using PubMed was undertaken. Then a questionnaire was designed which used a mix of open and closed questions.

Data collection took place between 1st October 2018 and 20th December 2018.

Data was collected from 28 patients during their final session of the ABC from the three Guy's and St Thomas's (GSTT) sites.

Outcomes

Thematic analysis was undertaken to draw out key themes from the responses to open questions.

  • 63% of patients felt like they understand their back pain 'very well'.
  • 55% of patients felt like they were 'very confident' in managing back pain themselves.
  • 62% off patients wanted more information about back pain.

 

Popular topics that patients preferred to learn more about included: managing a flare up, why does pain persist, relevance of posture and the influence of sleep on back pain.

Suggestions from patients themselves included; patient stories, information about the usefulness of scans and reasons for pain that is not biomechanical. Patients did want to know what the ´right´ and ´wrong´ exercises were. This may indicate a learning need regarding exercise preference in managing low back pain.

45% of patients preferred electronic delivery of information. 33% wanted a presentation and 22% preferred a booklet.

Out of 28 patients, 9 wanted written information delivered via email and 8 preferred brief e-learning videos.

Responses to open questions revealed that patients would like PDFs with links to informative websites and that any presentation should ideally be no more than 15 minutes.

52% of patients were 'very satisfied' with the class and 38% were ´completely satisfied´.
 


Results show that there would be value in adding an educational component to the ABC. Topics that patients would want to know more information about have been identified. Currently patient information within the class is provided as a booklet, whereas these results show that patients would prefer to receive information electronically.

Following any changes to the class a re-evaluation should take place to re-assess levels of health literacy and self-efficacy.

Further work should also focus on larger samples. Re-evaluation for any changes to the service should include outcome measures to be measured pre and post attendance of the class.

Implications

These recommendations could be used when designing an educational component for the Advanced Back Class at GSTT and other NHS back pain classes with similar patient profiles. For example, patients who are low to moderate risk using the STarT Back Tool.

Six education topics have been identified to be offered to patients in the ABC. These will be offered as education stations in addition to exercise stations. Attendance to any station is voluntary and is therefore patient preference led.

Funding acknowledgements

No. 

Additional notes

This work was presented at Physiotherapy UK 2019