Changes in general practitioners' sensitivity to patients' distress in low back pain consultations
Ligaya Butalid1, Peter F M Verhaak2, Jozien M Bensing3
1NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
Objective:
We aim to study GPs' sensitivity to patients' distress and communication on psychosocial factors prior to and after the introduction of the clinical guideline for low back pain.
Methods:
Consultations from previous studies on doctor-patient communication in the Netherlands were available for secondary analyses. We selected consultations in which patients presented low back pain complaints (N=168; 25 from 1989, 6 from 1995, 116 from 2001, 21 from 2008) and analyzed these consultations using the Roter Interaction Analysis System (RIAS) and the Verona Coding Definitions of Emotional Sequences (VR-CoDES).
Results:
GPs more often acknowledged psychosocial factors during consultations after implementation of the guideline for non-specific low back pain. Moreover, patients more often voiced their worries, while GPs put more emphasis on providing biomedical information and counseling during these consultations.
Conclusions:
GPs tend to emphasize biomedical factors rather than supporting their patients emotionally. Patients are likely to voice their worries implicitly, indicating they have a need for emotional support from their GPs.
Practice Implications:
GPs now face the challenge of not only recognizing psychosocial aspects during consultations with low back pain, but also actively eliciting concerns regarding these psychosocial aspects.
