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Research ArticleOriginal ResearchA

The Enduring Impact of What Clinicians Say to People With Low Back Pain

Ben Darlow, Anthony Dowell, G. David Baxter, Fiona Mathieson, Meredith Perry and Sarah Dean
The Annals of Family Medicine November 2013, 11 (6) 527-534; DOI: https://doi.org/10.1370/afm.1518
Ben Darlow
1Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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  • For correspondence: ben.darlow@otago.ac.nz
Anthony Dowell
1Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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G. David Baxter
2Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Fiona Mathieson
3Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Meredith Perry
2Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Sarah Dean
4Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
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Abstract

PURPOSE The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.

METHODS Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks’ duration) and 11 participants with chronic low back pain (more than 3 months’ duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.

RESULTS Participants’ underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding. Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients’ understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years. Many messages from clinicians were interpreted as meaning the back needed to be protected. These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed. Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.

CONCLUSIONS Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs.

  • low back pain
  • attitude
  • patients
  • health personnel
  • physician-patient relations
  • health knowledge
  • attitudes
  • practice
  • Received for publication September 9, 2012.
  • Revision received December 20, 2012.
  • Accepted for publication January 2, 2013.
  • © 2013 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 11 (6)
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Vol. 11, Issue 6
November/December 2013
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The Enduring Impact of What Clinicians Say to People With Low Back Pain
Ben Darlow, Anthony Dowell, G. David Baxter, Fiona Mathieson, Meredith Perry, Sarah Dean
The Annals of Family Medicine Nov 2013, 11 (6) 527-534; DOI: 10.1370/afm.1518

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The Enduring Impact of What Clinicians Say to People With Low Back Pain
Ben Darlow, Anthony Dowell, G. David Baxter, Fiona Mathieson, Meredith Perry, Sarah Dean
The Annals of Family Medicine Nov 2013, 11 (6) 527-534; DOI: 10.1370/afm.1518
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