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Paired interviews of shared experiences around chronic low back pain : classic mismatch between patients and their doctors
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Allegretti, Andrew, Borkan, Jeffrey M., Reis, Shmuel and Griffiths, Frances (2010) Paired interviews of shared experiences around chronic low back pain : classic mismatch between patients and their doctors. Family Practice, Vol.27 (No.6). pp. 676-683. doi:10.1093/fampra/cmq063 ISSN 0263-2136.
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Official URL: http://dx.doi.org/10.1093/fampra/cmq063
Abstract
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.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) |
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| Library of Congress Subject Headings (LCSH): | Backache -- Treatment, Physician and patient, Chronic diseases -- Treatment, Qualitative research | ||||
| Journal or Publication Title: | Family Practice | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 0263-2136 | ||||
| Official Date: | December 2010 | ||||
| Dates: |
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| Volume: | Vol.27 | ||||
| Number: | No.6 | ||||
| Number of Pages: | 8 | ||||
| Page Range: | pp. 676-683 | ||||
| DOI: | 10.1093/fampra/cmq063 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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