Does the Presence of Psychosocial "Yellow Flags" Alter Patient-Provider Communication for Work-Related, Acute Low Back Pain?

Objective: To determine whether patterns of patient-provider communication might vary depending on psychosocial risk factors for back disability. Methods: Working adults (N = 97; 64% men; median age = 38 years) with work-related low back pain completed a risk factor questionnaire and then agreed to...

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Bibliographic Details
Published in:Journal of occupational and environmental medicine 2009-09, Vol.51 (9), p.1032-1040
Main Authors: Shaw, William S., Pransky, Glenn, Winters, Thomas, Tveito, Torill H., Larson, Susan M., Roter, Debra L.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Age Factors
Analysis of Variance
Back pain
Biological and medical sciences
Cohort Studies
Communication
Disability
Disability Evaluation
Diseases of the osteoarticular system
Diseases of the spine
Female
Humans
Incidence
Low Back Pain - epidemiology
Low Back Pain - etiology
Low Back Pain - psychology
Male
Medical sciences
Mental Health
Middle Aged
Occupational Diseases - diagnosis
Occupational Diseases - epidemiology
Occupational Diseases - psychology
Occupational health
Occupational psychology
ORIGINAL ARTICLES
Physician-Patient Relations
Predictive Value of Tests
Probability
Psychology
Risk Assessment
Risk factors
Severity of Illness Index
Sex Factors
Stress, Psychological
Surveys and Questionnaires
Workplace
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Summary:Objective: To determine whether patterns of patient-provider communication might vary depending on psychosocial risk factors for back disability. Methods: Working adults (N = 97; 64% men; median age = 38 years) with work-related low back pain completed a risk factor questionnaire and then agreed to have provider visits audiotaped. Verbal exchanges were divided into utterances and coded for content, then compared among low-, medium-, and high-risk patients. Results: Among high-risk patients only, providers asked more biomedical questions, patients provided more biomedical information, and providers used more language to engage patients and facilitate communication. There were no group differences in psychosocial exchanges. Conclusions: Clinicians may recognize the need for more detailed assessment of patients with multiple psychosocial factors, but increases in communication are focused on medical explanations and therapeutic regimen, not on lifestyle and psychosocial factors.
ISSN:1076-2752
1536-5948
DOI:10.1097/JOM.0b013e3181b2f539