{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:22:53Z","timestamp":1777663373482,"version":"3.51.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health (London)"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Theoretical and practical guidance on how to navigate uncertainties in healthcare are scarce. Here, we draw from Gibson\u2019s ethic of openness to explore clinicians\u2019 experiences navigating uncertainty with individuals who experience low back pain (LBP) and provide guidance on avenues for navigating uncertainty in LBP and healthcare more broadly. Our analysis suggests that clinicians practice within different philosophical commitments when providing care for individuals with LBP, with some of them aligning with a (post)positivist approach with pre-determined endpoints and others an ethic of openness, with no fixed endpoints and consideration of multiple options and perspectives. Based on our analysis, an ethic of openness may help to surface these philosophical commitments, creating space for possibilities other than denying uncertainty and oversimplifying (evidence-based) practice. We argue that an ethic of openness may assist clinicians to navigate uncertainty in fruitful ways \u2013 embracing uncertainty, engaging in reflexivity and creativity, moving clinicians to directions that are likely to best meet the needs of patients.<\/jats:p>","DOI":"10.1177\/13634593241310383","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T12:45:26Z","timestamp":1741869926000},"page":"609-632","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating uncertainty in low back pain care through an ethic of openness: Learnings from a post-critical analysis"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-5408","authenticated-orcid":false,"given":"Nathalia","family":"Costa","sequence":"first","affiliation":[{"name":"The University of Queensland\u2019s Clinical Trial Capability (ULTRA) Team, Faculty of Health, Medicine and Behavioural Sciences, Brisbane, QLD, Australia"},{"name":"School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebcca","family":"Olson","sequence":"additional","affiliation":[{"name":"School of Social Science, The University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Dillon","sequence":"additional","affiliation":[{"name":"School of Social Science, The University of Queensland, Brisbane, QLD, Australia"},{"name":"Physiotherapy Department, Royal Brisbane and Women\u2019s Hospital, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karime","family":"Mescouto","sequence":"additional","affiliation":[{"name":"RECOVER Injury Centre, The University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prudence","family":"Butler","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia"},{"name":"Physiotherapy Department, Royal Brisbane and Women\u2019s Hospital, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roma","family":"Forbes","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Setchell","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0258(20001215)19:23<3291::AID-SIM627>3.0.CO;2-T"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-017-7230-3"},{"key":"e_1_3_4_4_1","volume-title":"An Invitation to Reflexive Sociology","author":"Bourdieu P","year":"1992","unstructured":"Bourdieu P, Wacquant LJD (1992) An Invitation to Reflexive Sociology. London: Polity Press."},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daae049"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4173"},{"key":"e_1_3_4_7_1","unstructured":"Chartered Society of Physiotherapy (2024) What is evidence. Chartered Society of Physiotherapy. Available at: www.csp.org.uk\/professional-clinical\/clinical-evidence\/evidence-based-practice\/what-evidence (accessed January 2024)."},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2022.03.235"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115422"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2022.2040615"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-024-01222-7"},{"key":"e_1_3_4_12_1","volume-title":"The Foundations of Social Researcheaning and Perspective in the Research Process","author":"Crotty M","year":"1998","unstructured":"Crotty M (1998) The Foundations of Social Research: Meaning and Perspective in the Research Process. New York: Allen & Unwin."},{"key":"e_1_3_4_13_1","volume-title":"Explaining Society","author":"Danermark B","year":"2001","unstructured":"Danermark B, Ekstrom M, Jakobsen L, et al. (2001) Explaining Society. London: Taylor & Francis Group."},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490060092030"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31592-6"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/107327480901600208"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003838"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-016-9714-5"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490170092032"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1353\/abr.2017.0077"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.063289"},{"key":"e_1_3_4_22_1","article-title":"Diagnostic uncertainty in musculoskeletal pain: Implications for physiotherapy education","author":"Forbes R","year":"2022","unstructured":"Forbes R, Toloui-Wallace J (2022) Diagnostic uncertainty in musculoskeletal pain: Implications for physiotherapy education. OpenPhysio Journal 3: 1\u20135.","journal-title":"OpenPhysio Journal"},{"key":"e_1_3_4_23_1","doi-asserted-by":"crossref","unstructured":"Fortuna KL Hudson MF Myers A et al. (2022) How can we achieve health equity? Revisit the premise informing the scientific method [https:\/\/doi.org\/10.1111\/hex.13369]. Health Expectations 25(1): 1\u20133.","DOI":"10.1111\/hex.13369"},{"key":"e_1_3_4_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30489-6"},{"key":"e_1_3_4_25_1","volume-title":"The Order of Things: An Archaeology of the Human Sciences","author":"Foucault M","year":"1966","unstructured":"Foucault M (ed.) (1966) The Order of Things: An Archaeology of the Human Sciences, vol. 10, 1st edn. Paris: Routledge.","edition":"1"},{"key":"e_1_3_4_26_1","volume-title":"Society Must Be Defended: Lectures at the Coll\u00e8ge de France, 1975\u20131976","author":"Foucault M","year":"2003","unstructured":"Foucault M (2003) Society Must Be Defended: Lectures at the Coll\u00e8ge de France, 1975\u20131976. New York: Picador."},{"key":"e_1_3_4_27_1","doi-asserted-by":"publisher","DOI":"10.2307\/3349705"},{"key":"e_1_3_4_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7316.799"},{"key":"e_1_3_4_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7473.1013"},{"key":"e_1_3_4_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05213-1"},{"key":"e_1_3_4_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2019.1579308"},{"key":"e_1_3_4_32_1","doi-asserted-by":"publisher","DOI":"10.1201\/b19085"},{"key":"e_1_3_4_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_3_4_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_3_4_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1089-4"},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.7326\/ACPJC-1991-114-2-A16"},{"key":"e_1_3_4_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.14031"},{"key":"e_1_3_4_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7153.273"},{"key":"e_1_3_4_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-6988.2006.00041.x"},{"key":"e_1_3_4_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0020124"},{"key":"e_1_3_4_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2012.00170.x"},{"key":"e_1_3_4_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077800412471510"},{"key":"e_1_3_4_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0379-x"},{"key":"e_1_3_4_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/14427591.2014.888970"},{"key":"e_1_3_4_45_1","first-page":"108","volume-title":"The Sage Handbook of Qualitative Research","author":"Lincoln YS","year":"2018","unstructured":"Lincoln YS, Lynham SA, Guba EG (2018) Paradigmatic controversies, contradictions, and emerging confluences, revisited. In: Lincoln YS, Denzin NK (eds) The Sage Handbook of Qualitative Research, 5th edn. Los Angeles: Sage, pp.108\u2013150.","edition":"5"},{"key":"e_1_3_4_46_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp17X690941"},{"key":"e_1_3_4_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1851783"},{"key":"e_1_3_4_48_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203927076"},{"key":"e_1_3_4_49_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2021.10536"},{"key":"e_1_3_4_50_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781108264907"},{"key":"e_1_3_4_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267194"},{"key":"e_1_3_4_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12748"},{"key":"e_1_3_4_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363459320912830"},{"key":"e_1_3_4_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363459309360796"},{"issue":"2","key":"e_1_3_4_55_1","doi-asserted-by":"crossref","DOI":"10.1378\/chest.95.2_Supplement.2S","article-title":"Rules of evidence and clinical recommendations on the use of antithrombotic agents","volume":"95","author":"Sackett DL","year":"1989","unstructured":"Sackett DL (1989) Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95(2 Suppl): 2s\u20134s.","journal-title":"Chest"},{"key":"e_1_3_4_56_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2017.0602"},{"key":"e_1_3_4_57_1","volume-title":"Leaky Bodies and Boundaries : Feminism, Postmodernism and (Bio)ethics","author":"Shildrick M","year":"1997","unstructured":"Shildrick M (1997) Leaky Bodies and Boundaries : Feminism, Postmodernism and (Bio)ethics. New York: Routledge."},{"key":"e_1_3_4_58_1","doi-asserted-by":"publisher","DOI":"10.7551\/mitpress\/2842.003.0004"},{"key":"e_1_3_4_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-04860-8"},{"key":"e_1_3_4_60_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1606402"},{"key":"e_1_3_4_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2022.2068679"},{"key":"e_1_3_4_62_1","doi-asserted-by":"publisher","DOI":"10.1080\/13603124.2012.696710"},{"key":"e_1_3_4_63_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077800420931142"},{"key":"e_1_3_4_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9566.2008.01146.x"},{"key":"e_1_3_4_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102551"},{"key":"e_1_3_4_66_1","first-page":"1","article-title":"Systems to rate the strength of scientific evidence","volume":"47","author":"West S","year":"2002","unstructured":"West S, King V, Carey TS, et al. (2002) Systems to rate the strength of scientific evidence. Evidence Report\/Technology Assessment 47: 1\u201311.","journal-title":"Evidence Report\/Technology Assessment"},{"key":"e_1_3_4_67_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12752"},{"key":"e_1_3_4_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1314"}],"container-title":["Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13634593241310383","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13634593241310383","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13634593241310383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:32:09Z","timestamp":1777447929000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13634593241310383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,13]]},"references-count":67,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/13634593241310383"],"URL":"https:\/\/doi.org\/10.1177\/13634593241310383","relation":{},"ISSN":["1363-4593","1461-7196"],"issn-type":[{"value":"1363-4593","type":"print"},{"value":"1461-7196","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,13]]}}}