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初级保健中患者对腰痛治疗的看法:关于希望、期望和经历的定性研究

Patient perspectives on low back pain treatment in primary care: a qualitative study of hopes, expectations, and experiences.

作者信息

Madsen Simon Dyrløv, Stochkendahl Mette Jensen, Morsø Lars, Andersen Merethe Kirstine, Hvidt Elisabeth Assing

机构信息

Centre for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark.

Chiropractic Knowledge Hub, Odense M, 5230, Denmark.

出版信息

BMC Musculoskelet Disord. 2024 Dec 5;25(1):997. doi: 10.1186/s12891-024-08116-3.

Abstract

BACKGROUND

Patients' hopes and expectations for low back pain treatment influence their consultation experiences and treatment outcomes. These hopes and expectations may evolve over time, potentially leading to a shift in what patients consider important before and after a consultation. Understanding the distinction between hopes and expectations, and how they evolve is important for improving patient care. This study explored patients' hopes and expectations prior to LBP consultations and examined how these were reflected in their post-consultation experiences.

METHODS

We employed a qualitative design consisting of individual semi-structured pre- and post-consultation interviews with patients seeking care for low back pain from general practitioners, physiotherapists, and chiropractors in Denmark. A convenience sample of 18 patients (10 females and 8 males) aged between 28 and 79 years were interviewed about their hopes and expectations before a consultation and their experiences immediately following the consultation. Data were analysed employing Braun and Clarke's thematic analysis.

RESULTS

Two themes with five subthemes were developed: (1) "Something needs to be done," which included subthemes related to life disruption, expectations of clinical assessment, and the clinicians as experts; and (2) "Experiences and emotional responses to the interaction with the clinician", highlighting the importance of trust and the personal attributes of clinicians. Patients initially sought urgent help and clarity regarding their condition but shifted their focus post-consultation to the relational dynamics and emotional engagement experienced during interactions with clinicians.

CONCLUSIONS

This study contributes to the understanding of how patients' hopes and expectations regarding low back pain consultations evolve, shifting from a focus on clinical actions and outcomes to valuing interpersonal relationships and emotional support from clinicians. Recognising these shifts can enhance clinician-patient interactions and improve overall patient satisfaction and treatment outcomes.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

患者对腰痛治疗的希望和期望会影响他们的就诊体验和治疗效果。这些希望和期望可能会随着时间的推移而演变,这可能会导致患者在就诊前后对重要事项的看法发生转变。了解希望和期望之间的区别以及它们如何演变对于改善患者护理至关重要。本研究探讨了患者在腰痛就诊前的希望和期望,并研究了这些希望和期望如何在他们的就诊后体验中得到体现。

方法

我们采用了定性设计,包括对在丹麦向全科医生、物理治疗师和脊医寻求腰痛治疗的患者进行的个体半结构化就诊前和就诊后访谈。对18名年龄在28至79岁之间的患者(10名女性和8名男性)进行了便利抽样访谈,了解他们在就诊前的希望和期望以及就诊后立即的体验。采用布劳恩和克拉克的主题分析法对数据进行分析。

结果

形成了两个主题和五个子主题:(1)“需要采取行动”,包括与生活干扰、临床评估期望以及临床医生作为专家相关的子主题;(2)“与临床医生互动的体验和情感反应”,强调了信任和临床医生个人特质的重要性。患者最初寻求针对其病情的紧急帮助和明确诊断,但在就诊后将重点转移到了与临床医生互动期间体验到的关系动态和情感投入上。

结论

本研究有助于理解患者对腰痛就诊的希望和期望如何演变,从关注临床行动和结果转变为重视与临床医生的人际关系和情感支持。认识到这些转变可以增强医患互动,提高患者总体满意度和治疗效果。

临床试验编号

不适用。

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