Improving consultations for persistent musculoskeletal low back pain in orthopaedic spine settings: an intervention development
| Autor: | Lisa Roberts, Alison H. McGregor, Naffis Anjarwalla, Philip Sell, Tamar Pincus, Kathrin Braeuninger-Weimer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Sports medicine medicine.medical_treatment Psychological intervention EMPATHY Diseases of the musculoskeletal system Musculoskeletal low back pain VALIDATION Spinal care PHYSICIANS FUSION Rheumatology PATIENT COMMUNICATION Intervention (counseling) SURGEONS medicine Humans Orthopedics and Sports Medicine Active listening Referral and Consultation Reassurance Rehabilitation Science & Technology business.industry Research Self-Management 1103 Clinical Sciences CARE Patient Acceptance of Health Care Low back pain Distress Orthopedics CONTEXT RC925-935 Physical therapy medicine.symptom business Life Sciences & Biomedicine Low Back Pain Patient education |
| Zdroj: | BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021) |
| Popis: | Background There is a need to improve consultations between patients with persistent musculoskeletal low back pain and orthopaedic spine clinicians when surgery is not indicated. Poor communication and lack of education about self- management in these consultations have been shown to be associated with increased distress and higher subsequent health care seeking. Aim To develop a standardised intervention to improve spine care consultations for patients for whom surgery is not beneficial. Method The intervention was developed in six stages. The first three stages included: interviews with patients, an interactive workshop with clinicians from a mix of disciplines, and interviews with spine clinicians about their perspective of the recommendations, their perceived difficulties and potential improvements. Information from these stages was synthesised by an expert panel, creating a draft intervention structure and content. The main features of the intervention and the materials developed were then reviewed by patients and spine clinicians. Finally, the research team incorporated the recommended amendments to produce the intervention. Results In total, 36 patients and 79 clinicians contributed to the development of the intervention. The final intervention includes three components: a pre-consultation letter with information suggesting that surgery is one possible intervention amongst many, introducing the staff, and alerting patients to bring with them a potted history of interventions tried previously. The intervention includes short online training sessions to improve clinicians’ communication skills, during the consultation, in reference to listening skills, validation of patients’ pain, and use of appropriate language. Clinicians are also supplied with a list of evidence-based sources for advice and further information to share with patients. Finally, post consultation, a follow up letter includes a short summary of the patients’ clinical journey, the results of their examination and tests, and a reminder of recommendations for self-management. Conclusion The intervention includes aspects around patient education and enhanced clinician skills. It was developed with input from a multitude of stakeholders and is based on patients’ perceptions of what they would find reassuring and empowering when surgery is excluded. The intervention has the potential to improve the patients care journey and might lead to changes in practice in spine clinicians. |
| Databáze: | OpenAIRE |
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