Factors associated with adherence to physiotherapeutic treatment in patients with chronic low back pain: A qualitative approach

Abstract

Introduction: The effectiveness of physiotherapeutic treatment in patients with chronic low back pain depends significantly on patient adherence, which is influenced by various factors, including the need for comprehensive care, adequate patient-therapist communication, and the patient’s socioeconomic contingencies. Objective: To identify variables perceived by patients that influence treatment adherence. Methods: A qualitative methodology was adopted, using semi-structured interviews to collect data from patients undergoing treatment at a physiotherapy teaching clinic. The sample was selected by convenience, including adult males and females with non-specific chronic low back pain. The interviews were transcribed and subjected to qualitative content analysis to identify themes related to patients’ self-perception of treatment adherence. Data collection was performed through individual interviews with a pre-established guiding script of open and closed questions, divided into thematic axes: I – Psychosocial Factors; II – Communication and Professional-Patient Relationship; III – Behavioral and Motivational Factors. Results: Content analysis revealed three main themes regarding patients’ perception of adherence to physiotherapeutic treatment: (I) Family support, (II) Expectation of improvement, and (III) Perception of pain relief. Many patients emphasized the crucial role of family support to ensure the continuity of treatment. The perception that physiotherapy can prevent more invasive interventions, such as surgeries, and improve quality of life was also identified as a motivating factor by the interviewees. In addition, recognizing progressive pain relief was noted as a central reason to continue the treatment. Conclusion: Adherence to physiotherapeutic treatment in patients with non-specific chronic low back pain is multifactorial, being significantly influenced by family support, expectation of improvement, and perception of pain relief. Therefore, strategies to strengthen the patient-therapist relationship, promote family involvement, and highlight the benefits of the treatment should be considered throughout therapeutic approaches.