| Summary: | Background: Involving patients in making decisions about the management of health conditions enables clinicians (including physiotherapists) and patients to deliberate about options and share information about the clinical situation; this may help to improve patients’ adherence and self-control over their illnesses. Low back pain (LBP) is a common and debilitating problem often managed by physiotherapists. The preferences of these patients and physiotherapists for involvement in decision making and, more specifically, those of patients and physiotherapists in Arabian cultures such as Saudi Arabia is largely unknown. Aim: to explore the perceptions and preferences of physiotherapists and patients with LBP for patient involvement in decision making and information provision. Research Design: This exploratory study was conducted in Saudi Arabia using a mixed methods approach, employing structured questionnaires followed by in-depth focus groups. Methods: Phase 1: A cross-sectional study was conducted with patients with LBP (n=296) and physiotherapists (n=93) using self-completion questionnaires developed for this study to examine the above aim. Phase 2: Ten focus group studies were carried out with participants to examine the reasons for their preferences. Analysis: Descriptive and inferential statistics were conducted to examine quantitative data; verbal transcripts were analysed using framework analysis. Results: Most patients preferred to adopt a more passive role in decision making within the clinical setting, but wished to share decisions about aspects occurring elsewhere (e.g., routine daily activities and home management programs). Patients' demographic and LBP characteristics were generally significantly associated with their preferences (p < 0.001-0.05). Physiotherapists were generally paternalistic in their approach to decision making. The in-depth information derived from the focus groups confirmed the questionnaire findings and provided some reasons for participant’s preferences. Conclusion: These findings provide information on which to base future studies to investigate the possible effect of preferences on treatment outcomes and the long term ‘self-management’ of LBP.
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