Background: The purpose of this study was to explore physiotherapists’ knowledge, attitude, and practice
behavior in assessing and managing patients with non-specific, non-traumatic, acute- and subacute neck pain,
with a focus on prognostic factors for chronification.
Method: A qualitative study using in-depth semi-structured interviews was conducted with 13 physiotherapists
working in primary care. A purposive sampling method served to seek the broadest perspectives. The knowledgeattitude
and practice framework was used as an analytic lens throughout the process. Textual data were analyzed
using qualitative content analysis with an inductive approach and constant comparison.
Results: Seven main themes emerged from the data; physiotherapists self-estimated knowledge and attitude, role
clarity, therapeutic relationship, internal- and external barriers to practice behavior, physiotherapists’ practice
behaviors, and self-reflection. These findings are presented in an adjusted knowledge-attitude and practice
behavior framework.
Conclusion: A complex relationship was found between a physiotherapist’s knowledge about, attitude, and
practice behavior concerning the diagnostic process and interventions for non-specific, non-traumatic, acute, and
subacute neck pain. Overall, physiotherapists used a biopsychosocial view of patients with non-specific neck
pain. Physiotherapists’ practice behaviors was influenced by individual attitudes towards their professional role
and therapeutic relationship with the patient, and individual knowledge and skills, personal routines and habits,
the feeling of powerlessness to modify patients’ external factors, and patients’ lack of willingness to a biopsychosocial
approach influenced physiotherapists’ clinical decisions. In addition, we found self-reflection to
have an essential role in developing self-estimated knowledge and change in attitude towards their therapeutic
role and therapist-patient relationship.
