Low back pain is a major health problem in primary care and is associated with a substantial clinical, economic, and societal burden. Although evidence-based recommendations are available, its management remains heterogeneous, poorly coordinated, and often characterized by overmedicalization. In this context, interprofessional collaboration has been identified as a means of improving primary care but does not necessarily ensure a shared understanding of clinical situations. Collaborative Clinical Reasoning (CCR), defined as the process of developing a shared mental model among healthcare professionals and patient partners, remains insufficiently explored in primary care.
This exploratory qualitative study aims to explore the representations and definitions of Collaborative Clinical Reasoning among general practitioners, physiotherapists, and patient partners with low back pain in French-speaking Belgium. It also aims to examine how CCR is implemented in primary care practice and to identify perceived barriers and facilitators to its implementation.
Data will be collected through separate focus groups involving general practitioners, physiotherapists, and patient partners with low back pain. Qualitative data will be analyzed using inductive reflexive thematic analysis.
Be a general practitioner or a physician in postgraduate training in general practice.
Practice general medicine in French-speaking Belgium.
Practice general medicine in primary care.
Be a physiotherapist.
Practice exclusively in a nursing home or a nursing home with skilled nursing care.
Be on sick leave during the study (e.g., work incapacity).
Have a known specific lumbar pathology (e.g., fracture, infection, cancer, lumbar radiculopathy, etc).
Have a known general condition that may explain the low back pain (e.g., fibromyalgia, osteoporosis, rheumatologic disease, etc).
Single group
Focus groups and deliberative workshop
Other interventionGeneral practitioners, physiotherapists, and patients will first participate in separate focus groups for each stakeholder group. A subsequent mixed deliberative workshop will bring together participants from the three stakeholder groups to discuss and refine the findings.
Participants' representations and definitions of Collaborative Clinical Reasoning, identified through reflexive thematic analysis.
Participants' representations and definitions of Collaborative Clinical Reasoning will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
Enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.
The enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
Barriers and facilitators to the enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.
Barriers and facilitators influencing the enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
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