{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T20:10:52Z","timestamp":1772223052390,"version":"3.50.1"},"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical guidelines for the management of low back pain (LBP) emphasize the importance of reassuring patients, as this reduces concern and increases confidence in recovery. Although physiotherapists (PTs) often use reassurance strategies, the perception of the different reassuring messages remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate perceptions of confidence of different reassurance messages delivered by PTs to people with LBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A survey was conducted among 544 participants with LBP. The survey included 21 reassuring messages divided into six themes \u2018\n                      <jats:italic>\n                        <jats:italic>Prevalence and statistics\u2019, \u2018Red flag\u2019, \u2018Natural healing\u2019, \u2018Imaging\u2019, \u2018Treatment strategies\u2019,<\/jats:italic>\n                      <\/jats:italic>\n                      and\n                      <jats:italic>\n                        <jats:italic>\u2018Pain physiology\u2019<\/jats:italic>\n                      <\/jats:italic>\n                      . Participants had to rate the extent to which each message increased their confidence using a 5-point Likert scale. Messages were categorized into four levels of perceived confidence based on participants\u2019 responses: high (\u226580% rated the message as \u2018provide confidence\u2019 or \u2018significantly provide confidence\u2019), moderate (60\u201379%), low (40\u201359%) and very low (\u226440%). Correlation and non-parametric analyses examined the relationships between confidence ratings, demographic variables and personality traits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Messages that emphasized patient autonomy and the absence of red flags were perceived as particularly reassuring and received the highest ratings (\u226580%). In contrast, messages that referred to natural healing and the neurophysiology of pain were perceived as less effective in providing confidence. Personality traits and background characteristics had minimal effects on perceived reassurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reassuring communication that emphasizes patient autonomy and the low likelihood of serious pathology can boost confidence in individuals with LBP and may be more impactful than patient-specific characteristics. These findings may help PTs refine their communication strategies and strengthen therapeutic relationships, potentially leading to better treatment outcomes. Future research should explore the implications of these findings in clinical settings in real-life interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0323580","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T17:41:03Z","timestamp":1756834863000},"page":"e0323580","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The perception of individuals with low back pain regarding reassuring information: Insights based on physiotherapists messages"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-536X","authenticated-orcid":true,"given":"Ron","family":"Shavit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talma","family":"Kushnir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0870-3723","authenticated-orcid":true,"given":"Yaniv","family":"Nudelman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2589-1968","authenticated-orcid":true,"given":"Shmuel","family":"Springer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"issue":"2","key":"pone.0323580.ref001","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/10669817.2017.1390652","article-title":"Physical therapy clinical specialization and management of red and yellow flags in patients with low back pain in the United States","volume":"26","author":"CE Ladeira","year":"2018","journal-title":"J Man Manip Ther"},{"issue":"4","key":"pone.0323580.ref002","doi-asserted-by":"crossref","first-page":"470","DOI":"10.2522\/ptj.20120137","article-title":"The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain","volume":"93","author":"PH Ferreira","year":"2013","journal-title":"Phys Ther"},{"key":"pone.0323580.ref003","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","author":"ML Ferreira","year":"2023","journal-title":"The Lancet Rheumatology"},{"issue":"10137","key":"pone.0323580.ref004","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"What low back pain is and why we need to pay attention","volume":"391","author":"J Hartvigsen","year":"2018","journal-title":"Lancet"},{"issue":"10137","key":"pone.0323580.ref005","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1016\/S0140-6736(18)30489-6","article-title":"Prevention and treatment of low back pain: evidence, challenges, and promising directions","volume":"391","author":"NE Foster","year":"2018","journal-title":"Lancet"},{"key":"pone.0323580.ref006","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1186\/s12891-016-1144-2","article-title":"Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: a cross-sectional study","volume":"17","author":"N Holt","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"issue":"11","key":"pone.0323580.ref007","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1016\/j.pain.2013.07.019","article-title":"Cognitive and affective reassurance and patient outcomes in primary care: a systematic review.","volume":"154","author":"T Pincus","year":"2013","journal-title":"Pain\u00ae"},{"issue":"2","key":"pone.0323580.ref008","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/AJP.0000000000000097","article-title":"Effective reassurance in primary care of low back pain: what messages from clinicians are most beneficial at early stages?","volume":"31","author":"MI Hasenbring","year":"2015","journal-title":"Clin J Pain"},{"issue":"10","key":"pone.0323580.ref009","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1002\/ejp.1639","article-title":"Individuals with back and neck pain on medical forums: What do they mention? 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