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Medical Factors
Good explanation of the condition by the treater results in patient satisfaction with treatment of acute low back pain.

At a glance:
Low-back pain is a common complaint and the precise cause is often unknown. Good communication between a patient with low-back pain and their doctor is important for patients.

This study found that regardless of how much their symptoms had improved, patients were more satisfied with the treatment they received when doctors:
Appeared to take a patients condition seriously
Explained the condition clearly
Gave advice on how to avoid getting injured again
Tried to understand the patient's job
Perspectives:
Employee
This study shows that communication about their problem is an important issue for patients with back pain. Patients wanted their treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 to take the condition seriously and explain what they could do to help themselves. The findings of this study are consistent with what patients are looking for in everyday practice.

Patients who have a good understanding of their back problem do better, in terms of rehabilitation
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 and recovery. They are more confident and more active, they learn how to manage their back problem and return to better levels of function.

Make sure you have the best advice about your back problem. Let your doctor and other treating practitioners know if you have concerns and fears about your condition, your job, or the future. Make sure you understand what you can do to improve your situation and back pain, and that returning to everyday activities helps most people with back problems. You may need to ask for a longer appointment, or arrange a second appointment with the doctor to allow enough time to thoroughly discuss these issues.

It often helps to take a written list of questions to the consultation.
Employer
Patients who are more satisfied with their treatment have higher levels of confidence in their ability to manage the condition. People who are more confident about their problem have better return to work outcomes.

Support the employee to get the best medical advice, understand their condition, and be confident about their problem. They may need a second appointment or a longer consultation. It often helps to take a written list of questions to the consultation.
Treater
This and other studies show that patients want good communication about their back pain. Treating practitioners sometimes consider that finding the diagnosis
diagnosis
The process of identifying a medical condition or disease by its symptoms, the findings from a medical examination, and from the results of various diagnostic procedures.
 is important for patients. Research tells us that we are not able to identify the exact cause of back pain for the majority of people. However we are able to provide good levels of advice about what patients can do to lessen their pain and improve their function.

Patients want their practitioners to take them seriously, and they want good levels of communication about the problem.

Encouraging people to remain active, return to everyday function and to keep mobile are important aspects of improving back problems. A comprehensive study on back pain prevention found that keeping active and exercising was the only effective way of reducing recurrences of back pain.
Insurer
Patients who understand their condition are more satisfied and are more likely to have better outcomes. Encourage people with a work-related back problem to ask questions and understand what they can do to help their back problem.
Original Article, Authors & Publication Details:
Shaw WSP1,2, Zaia AMS3, Pransky GM1,2, Winters TMD4, Patterson WBM5: (2005)

Perceptions of Provider Communication and Patient Satisfaction for Treatment of Acute
acute
A condition develops quickly and is often of short duration. The opposite of acute is chronic, which refers to a long term problem continuing for months to years.
 Low Back Pain.
Journal of Occupational & Environmental Medicine, 47(10):1036-1043.

1Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts
2Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
3Beth Israel Deaconess Medical Center, Needham Campus, Needham, Massachusetts
4Occupational and Environmental Health Network, Waltham, Massachusetts
5Occupational Health & Rehabilitation Inc, Hingham, Massachusetts
Background, Study Objectives, How It Was Done:
Low-back pain is a common symptom. The exact cause of back pain is not usually identified and treatment should be focused on care, education and reassurance. Communication between doctors and patients is important. In previous studies patients have reported dissatisfaction with the level of information from their doctor. When this happens they seek information from other sources, which might not be reliable. Patients' expectations influence their recovery, so poor quality information can be a serious problem.

Doctors face a number of challenges to communicate effectively about low-back pain. Doctors and patients might have different aims: patients seek medical advice because they want to find out the cause of their pain and get back to performing normal activities. The doctor's focus is usually on reaching a diagnosis and reducing the pain levels.

This study aimed to explore the link between effective communication and patient satisfaction after treatment for acute, work-related low-back pain. 512 patients at occupational health clinics in the United States completed a series of questionnaires. The patients had a work-related injury and were experiencing low-back pain for the first time. They worked in a variety of industries and had varying degrees of education ranging from 9 years of schooling to college education.

Information was obtained about the patient's background, their injury and their treatment. They were then followed-up at one and three months after their injury and asked how satisfied they were with their treatment. They were also asked to describe how well their doctor communicated with them by answering the following questions:

Did the doctor take the patients condition seriously?
Did the doctor explain their condition clearly?
Did the doctor give advice about how to avoid being injured again?
Did the doctor try to understand the patient's job?

Patients were also asked how much pain they were experiencing, how well they were able to carry out daily tasks and whether they had returned to work. The researchers were able to take these factors into account when they analysed how the doctor's communication had affected the patient's satisfaction with their treatment.
Study Findings:
Patients who were positive about their doctor's communication were more satisfied with their medical care, regardless of how much their condition had improved. At one and three months good communication was more important than an improvement in symptoms in determining a patient's level of satisfaction with their treatment.

Taking the patients condition seriously had the greatest effect on how happy they were with their care. The second most important factor was whether the doctor gave advice on how to avoid being injured again.

Overall, most patients reported that their doctor had communicated with them well. 86% believed their condition was taken seriously, 74% were advised on ways to prevent being injured again, 82% had their condition clearly explained to them and 85% thought their doctor had tried to understand their job. 84% were completely satisfied or mostly satisfied with their treatment and only 3% were completely unsatisfied.
Conclusions:
This study found patients are more likely to be satisfied with their back pain treatment if their doctor communicated well. It was important that the doctor made an effort to understand their position and provide them with clear information.

Good communication helps patients to:

Develop realistic expectations about their injury
Adopt strategies to manage their pain
Become aware of factors that will help or hinder their recovery

The researchers recommended doctors use open-ended questions to find out their patients concerns regarding their low-back pain and how it will affect their everyday lives and their work.

When low-back pain persisted for more than one month an improvement in symptoms became more important for patients. At this stage patients can become disheartened and frustrated with continuing pain and loss of function.

The patients in this study were selected from occupational health clinics where the doctors are more likely to be familiar with low-back pain and trained in its treatment. Low-back pain is often treated by general practitioners who have not received expert training. Doctors without specialised training may be less likely to communicate as effectively. In that case patients may be less happy with their treatment.
References:
PubMed Abstract
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