Self-Efficacy and Self-Management in Musculoskeletal Rehabilitation: Strategies and Challenges Among Brazilian Physiotherapists.

Abstract

Objectives: This study aimed to investigate the knowledge and strategies used by Brazilian physical therapists in assessing and promoting self-efficacy and self-management in musculoskeletal rehabilitation.

Methods: A nationwide cross-sectional online survey was conducted with licenced physical therapists recruited through professional networks and social media. The questionnaire, developed based on the CHERRIES checklist, assessed participants' knowledge, clinical strategies, and perceived barriers related to self-efficacy and self-management interventions. Data were analysed using descriptive statistics and logistic regression models.

Results: A total of 348 responses were analysed. While 97.7% of respondents acknowledged self-efficacy as a key factor in treatment adherence, only 43.6% frequently applied strategies to enhance it in clinical practice, as per Bandura's theory. The most commonly cited interventions were self-management education and exercises (81.2%). However, limited professional training and low patient adherence emerged as major barriers. Logistic regression analysis revealed that therapists who engaged more frequently with literature on the subject were 3.48 times more likely (95% CI: 1.6-7.4) to implement self-efficacy strategies in practice compared with those who engaged less frequently.

Conclusion: Despite acknowledging the importance of self-efficacy, Brazilian physical therapists face challenges in applying structured strategies in practice. Enhancing education and integrating behavioural approaches into curricula may facilitate the implementation of evidence based self-efficacy interventions.