From evidence to action: some suggestions for improving the effectiveness of educational strategies in secondary prevention
What do patients need to know? The central proposition underpinning this chapter is that for optimal self-management of LBP and its effects, knowledge per se is not what patients need, but rather they need information needed to develop, embed and maintain optimal pain coping strategies. In developing a strategy to achieve this however, patients need to understand the nature of their predicament, in this case the nature of LBP and its effects.
A number of key educational messages identified by Main et al. (2010a) are shown in Box 23.4. These key messages link across to a set of colloquial myths which act as obstacles to recovery and participation, and are summarized in Box 23.4. Surprisingly perhaps, the myths are not confined to patients: these beliefs are still held by some HCPs, irrespective of discipline.
Patients need to be offered a plausible understanding of LBP, in language which they understand, which shifts the primary focus from structural mechanisms, pathology and disease, to an understanding of LBP in terms of central pain mechanisms and the development of persistent pain/ disability within a biopsychosocial framework (Main et al. 2010b).
They may have unhelpful or mistaken beliefs about LBP and its relationship with pain-associated limitations and the suffering that accompanies persistent LBP. Main et al. (2010a) have highlighted three particularly important types of belief/expectations which need to be considered