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

Why This Matters

Low back pain (LBP) is one of the most common reasons for primary care visits. Patients’ expectations and emotional responses to their care significantly impact treatment outcomes and satisfaction. Understanding how these expectations shift before and after consultations can help clinicians tailor interactions to better meet patient needs.

What the Research Found

This qualitative study explored the hopes and expectations of 18 patients in Denmark who consulted general practitioners, physiotherapists, or chiropractors for low back pain. Using pre- and post-consultation interviews, researchers identified two overarching themes:

  1. “Something needs to be done”: Before consultations, patients often expressed urgency and a desire for action, clinical evaluation, and reassurance from experts.
  2. “Experiences and emotional responses to the interaction with the clinician”: After consultations, patients emphasized the importance of relational aspects such as feeling heard, trust, and the clinician’s empathy.

The study highlights that while patients initially seek diagnosis and intervention, their post-consultation reflections often center around emotional support and the quality of interpersonal interactions.

Clinical Takeaways

    • Recognize that patients with LBP may arrive with high expectations for clinical intervention.
    • Be aware that patient satisfaction is often shaped more by the quality of the clinician-patient interaction than by the intervention itself.
    • Empathy, listening skills, and trust-building can significantly enhance patient experiences.
    • Tailoring communication to acknowledge both physical concerns and emotional needs may improve outcomes.

Where Collaborative Spine Care May Support This

All healthcare providers can enhance outcomes by emphasizing patient-centered communication, fostering trust, and addressing both the clinical and emotional needs of patients with low back pain.

Reference
Madsen SD, Stochkendahl MJ, Morsø L, Andersen MK, Hvidt EA. Patient perspectives on low back pain treatment in primary care: a qualitative study of hopes, expectations, and experiences. BMC Musculoskelet Disord. 2024;25(1):997. doi:10.1186/s12891-024-08116-3.

View on Pubmed:  https://pubmed.ncbi.nlm.nih.gov/39639259/

ABSTRACT:

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 analyzed 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. Recognizing these shifts can enhance clinician-patient interactions and improve overall patient satisfaction and treatment outcomes.