Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations
| Autor: | Philip Sell, Kathrin Braeuninger-Weimer, Lisa Roberts, Naffis Anjarwalla, Tamar Pincus, Alison H. McGregor |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Referral Concordance media_common.quotation_subject back pain Terminology 1117 Public Health and Health Services surgery orthopaedic & trauma surgery Perception medicine Back pain Humans Referral and Consultation Qualitative Research media_common business.industry Ice Cream 1103 Clinical Sciences General Medicine Low back pain Orthopedics Family medicine Medicine Thematic analysis medicine.symptom business Low Back Pain Qualitative research 1199 Other Medical and Health Sciences |
| Zdroj: | BMJ Open BMJ Open, Vol 11, Iss 9 (2021) |
| ISSN: | 2044-6055 |
| Popis: | ObjectiveThis study aimed to explore the perceptions of orthopaedic clinicians about consultations for people with persistent musculoskeletal low back pain (PMLBP) in which surgery is not recommended. Surgery is not recommended for the majority of PMLBP consulting in secondary care settings.SettingSecondary care sector in the UK.ParticipantsSemi-structured qualitative interviews were conducted with 24 orthopaedic team clinicians from 17 different hospitals in the UK and Ireland. Interviews explored clinicians’ perceptions of the challenges in consultations where surgery is not indicated. Interviews were transcribed verbatim and analysed using thematic analysis.ResultsTwo meta-themes, Difficulties and Enablers, each consisting of several subthemes were identified. Difficulties included challenges around the choice of appropriate terminology and labels for PMLBP, managing patients’ expectations, working with mentally vulnerable patients and explaining imaging findings. Enablers included early management of expectations, use of routine imaging, triaging, access to direct referral elsewhere, including other non-surgical practitioners in the team, training to improve communication skills and understanding of psychological issues.ConclusionThe findings highlight clinicians’ perceived need for concordance in messages delivered across the care pathway and training of orthopaedic clinicians to deliver effective reassurance and address patients’ needs in circumstances where surgery is not indicated. |
| Databáze: | OpenAIRE |
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