Using critical reflexivity to challenge dominant discourses in low back pain care

Photo of a person looking through a microscope.

Using critical reflexivity to challenge dominant discourses in low back pain care

Photo of a person looking through a microscope.

A Queensland study has looked at the use of critical reflexivity as a tool to foster more socially just and equitable practices, specifically in low back pain (LBP) care.

In this study, the researchers sought to understand how clinicians looked at LBP in relation to broader socio-cultural-political aspects of care and how this changed after engaging in critically reflective dialogue with researchers.

Researchers conducted 22 dialogue sessions with clinicians and researchers at two health services providing LBP care, a private physiotherapy clinic specialising in musculoskeletal care and a public multidisciplinary pain clinic providing care for persistent pain and associated disability.

A total of 29 clinicians across the two services took part. Clinicians from the first site were physiotherapists, while those from the second site included occupation therapists, pain/addiction specialists, GPs and more.

Foucauldian discourse analysis methodology was used to analyse transcripts from each dialogue.

During the dialogues a series of recommendations were co-developed by the clinicians, the research team and an advisory group of people with lived experience of LBP, and these recommendations were also analysed.

The results, published in the Journal of Health Services Research & Policy, suggest that at both of these clinics, LBP care was mainly constructed at an individual level, with either the patient or the clinician as its object rather than social justice factors.

The participants from the private clinic initially focused more on individuals and less on the social aspects of care, while those from the public clinic identified broader social, political and cultural aspects.

Through the dialogues, these constructions were expanded to incorporate systems and workplace practices, fostering more equitable clinical and service practices such as assistance navigating the healthcare system, more consideration of socioeconomic circumstances while developing treatment plans and more inclusive workplace cultures.

The researchers concluded that critical reflexivity can be a useful tool in fostering equitable and socially just practices and suggested that it could be expanded to other health conditions and services.

Access the research paper here.



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