Journal
FAMILY PRACTICE
Volume 27, Issue 6, Pages 676-683Publisher
OXFORD UNIV PRESS
DOI: 10.1093/fampra/cmq063
Keywords
Chronic disease management; doctor-patient relationship; patient-centred care; pain; low back pain
Categories
Funding
- ESRC [ES/F032765/1] Funding Source: UKRI
- Economic and Social Research Council [ES/F032765/1] Funding Source: researchfish
- National Institute for Health Research [CSA03/003] Funding Source: researchfish
Ask authors/readers for more resources
Methods. In-depth interviews of a purposeful sample of paired chronic LBP patients and their doctors were conducted, transcribed and analysed using a multistep iterative process. Interview pairs were examined for important themes and major areas of convergence and divergence/mismatch. Results. Patients' stories focused on their suffering from severe and disabling LBP while conveying a high level of reliance on their family physicians. Physicians described many challenges in treating this patient population. Patient and doctor stories were convergent regarding the severity/seriousness of illness, the lack of effective treatments and the existence of many barriers to care. Notable areas of mismatch: biomedical/biomechanical versus biopsychosocial (BPS) models of illness, treatment expectations/goals of reducing pain versus improving function and the importance of a definitive diagnosis. Discussion. Patient and physician stories revealed shared themes and convergences, as well as significant discordance and mismatch. Family physicians, trained in and adherent to the BPS model, may have great difficulty when matched with biomechanically oriented patients. Re-conceptualizing doctors and LBP patients as a single teachable dyad may be useful. Clinical application of paired interviews of shared experiences may be useful in bridging communication and paradigmatic gaps, reducing mismatch and developing shared treatment plans.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available