The dilemma of diagnostic uncertainty when treating people with chronic low back pain: A qualitative study

Clinical Rehabilitation

Volumn 26, Issue 6, 2012, Pages 558-569

  Slade, Susan Carolyn ^a   Molloy, Elizabeth ^b   Keating, Jennifer Lyn ^b  

^a Department of Biomedical Science   (Australia)

^b MONASH UNIVERSITY   (Australia)

Author keywords

beliefs; Chronic low back pain; clinical communication; diagnostic uncertainty; exercise; qualitative research

Indexed keywords

ADULT; ARTICLE; CHRONIC DISEASE; HEALTH PERSONNEL ATTITUDE; HUMAN; HUMAN RELATION; INFORMATION PROCESSING; LOW BACK PAIN; PATIENT EDUCATION; PHYSIOTHERAPIST; PRIMARY HEALTH CARE; PSYCHOLOGICAL ASPECT; QUALITATIVE RESEARCH; TEACHER; UNCERTAINTY;

ADULT; ATTITUDE OF HEALTH PERSONNEL; CHRONIC DISEASE; FOCUS GROUPS; HUMANS; LOW BACK PAIN; MENTORS; PATIENT EDUCATION AS TOPIC; PHYSICAL THERAPISTS; PRIMARY HEALTH CARE; PROFESSIONAL-PATIENT RELATIONS; QUALITATIVE RESEARCH; UNCERTAINTY;

EID: 84861328566     PISSN: 02692155     EISSN: 14770873     Source Type: Journal    
DOI: 10.1177/0269215511420179     Document Type: Article

References (40)

1. Henschke N, Maher CG, Refshauge KM, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008 ; 337: 1-7
2. Hestbaeck L, Leboeuf-Yde C, Engberg M, et al. The course of low back pain in a general population. Results from a 5-year prospective study. J Manip Physiol Ther. 2003 ; 26: 213-220
3. Pengel L, Herbert RD, Maher CG, et al. Acute low back pain: systematic review of its prognosis. BMJ. 2003 ; 327: 323-325
4. Boos N, Lander PH. Clinical efficacy of imaging modalities in the diagnosis of low-back disorders. Eur Spine J. 1996 ; 5: 2-22
5. Chou R, Fu R, Carrino J, et al. Imaging strategies for low back pain: a systematic review and meta-analysis. Lancet. 2009 ; 373: 463-472
6. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002 ; 137: 586-597
7. Balague F, Cedraschi C. Radiological examination in low back pain patients: Anxiety of the patient? Anxiety of the therapist?. Joint Bone Spine. 2006 ; 73: 508-513
8. Verbeek J, Sengers M, Riemens A, et al. Patient expectations of treatment for back pain: a systematic review of qualitative and quantitative studies. Spine. 2004 ; 29: 2309-2318
9. Frantsve LME, Kerns RD. Patient-provider interactions in the management of chronic pain: current findings within the context of shared medical decision making. Pain Med. 2007 ; 8: 25-35
10. Parsons S, Harding G, Breen A, et al. The influence of patients' and primary care practitioners' beliefs and expectations about chronic musculoskeletal pain on the process of care. Clin J Pain. 2007 ; 23: 91-98
11. Norman G, Barraclough K, Dolovich L, et al. Iterative diagnosis. BMJ. 2009 ; 339: 747-748
12. Schmidt HG, Machiels-Bongaerts M, Hermans H, et al. The development of diagnostic competence: comparison of a problem-based, an integrated, and a conventional medical curriculum. Med Educ. 1996 ; 71: 658-664
13. Spafford MM, Schryer CF, Campbell SL, et al. Towards embracing clinical uncertainty. J Soc Work. 2007 ; 7: 155-178
14. Timmermans S, Angell A. Evidence-based medicine, clinical uncertainty and learning to doctor. J Health Soc Behav. 2001 ; 42: 342-359
15. Slade SC, Molloy E, Keating JL. Listen to me, tell me: a qualitative study of partnership in care for people with non-specific chronic low back pain. Clin Rehabil. 2009 ; 23: 270-280
16. Slade SC, Molloy E, Keating JL. People with on-specific chronic low back pain who have participated in exercise programs have preferences about exercise: a qualitative study. Aust J Physiother. 2009 ; 55: 115-121
17. Slade SC, Molloy E, Keating JL. Stigma experienced by people with non-specific chronic low back pain: a qualitative study. Pain Med. 2009 ; 10: 143-154
18. Savigny P, Kuntze S, Watson P, et al. Early management of persistent non-specific low back pain: summary of NICE guidance. BMJ. 2009 ; 338: 1805
19. Keller A, Hayden J, Bombardier C, et al. Effect sizes of non-surgical treatments of non-specific low back pain. Eur Spine J. 2007 ; 16: 1776-1788
20. Lingard L, Garwood K, Schryer CF, et al. A certain art of uncertainty: case presentation and the development of professional identity. Soc Sci Med. 2003 ; 56: 603-616
21. Geller G, Faden RR, Levine DM. Tolerance for ambiguity among medical students: implications for their selection, training and practice. Soc Sci Med. 1990 ; 31: 619-624
22. Pincus T, Foster NE, Vogel S, et al. Attitudes to back pain amongst musculoskeletal practitioners: a comparison of professional groups and practice settings using the ABS-mp. Man Ther. 2007 ; 12: 167-175
23. Elstein A, Schwarz A. Clinical problem solving and diagnostic decision making: selective review of the diagnostic literature. BMJ. 2002 ; 324: 729-732
24. Cresswell J Qualitative inquiry and research design: choosing among five traditions. 1998. Thousand Oaks, CA: Sage ; 1998 :
25. Krueger RA, Casey M Focus groups: a practical guide for applied research. 2000. Thousand Oaks, CA: Sage Publications ; 2000:
26. Rice PL, Ezzy D Qualitative research methods: a health focus. South Melbourne, Australia: Oxford University Press ; 1999:
27. Strauss A, Corbin J Basics of qualitative research: techniques and procedures for developing grounded theory. 1998. Thousand Oaks, CA: Sage Publishers ; 1998:
28. Kitzinger J. The methodology of focus groups: the importance of interaction between research participants. Sociol Health Illn. 1994 ; 16: 103-120
29. Miyata H, Kai I. Reconsidering evaluation criteria for scientific adequacy of health care research: an integrative framework of quantitative and qualitative research. Int J Qual Meth. 2009 ; 8: 64-75
30. Pope C, Ziebland S, Mays N. Qualitative research in health care: analysing qualitative data. BMJ. 2000 ; 320: 114-116
31. Kuper A, Lingard L, Levinson W. Critically appraising qualitative research. BMJ. 2008 ; 337: 687-692
32. Chibnall JT, Dabney A, Tait RC. Internist judgements of chronic low back pain. Pain Med. 2000 ; 1: 231-237
33. Tait RC, Chibnall JT, Kalauokalani D. Provider judgements of patients in pain: seeking symptom certainty. Pain Med. 2009 ; 10: 11-34
34. Lillrank A. Back pain and the resolution of diagnostic uncertainty in illness narratives. Soc Sci Med. 2003 ; 57: 1045-1054
35. Light D. Uncertainty and control in profressional training. J Health Soc Behav. 1970 ; 20: 310-322
36. Atkinson P. Training for certainty. Soc Sci Med. 1984 ; 19: 949-956
37. Gulbrandsen P, Madsen HB, Benth JS, et al. Health care providers communicate less well with patients with chronic low back paina study of encounters at a back pain clinic in Denmark. Pain. 2010 ; 150: 458-461
38. Mounsey AL, Bovbjerg V, White LL, et al. Do students develop better motivational interviewing skills through role-play with standardised patients or with student colleagues?. Med Educ. 2006 ; 40: 775-780
39. Rosenbaum ME, Ferguson KJ, Lobas JG. Teaching medical students and residents skills for delivering bad news: a review of strategies. Acad Med. 2004 ; 79: 107-117
40. Fox R The student physician. Merton RK Reader G Kendall PL, ed. Cambridge: Harvard University Press ; 1957: