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Can Patients With Low Back Pain Be Satisfied With Less Than Expected?
Wouter L Silvis1,2, Sandra E Lakke2, Patrick Stegeman3
1Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Spine
|April 2, 2016
Summary
Patient expectations for disability reduction in chronic low back pain (CLBP) were explored. While pretreatment expectations slightly influenced satisfaction, many patients remained satisfied even without treatment success.
Area of Science:
- Rehabilitation Medicine
- Psychometrics
- Health Services Research
Background:
- Limited evidence exists on factors influencing treatment satisfaction in chronic low back pain (CLBP).
- The specific role of patient expectations regarding disability reduction post-treatment requires further investigation.
Purpose of the Study:
- To evaluate the psychometric properties of a novel baseline disability questionnaire assessing patient expectations.
- To examine the relationship between treatment success and patient satisfaction in CLBP.
- To determine the likelihood of satisfaction with care when treatment outcomes do not meet expectations.
Main Methods:
- A prospective cohort study involving 609 patients with CLBP, utilizing a modified Pain Disability Index (PDI) for baseline expectations.
- Exploratory factor analysis was conducted on the new questionnaire.
- Binary logistic regression analyzed predictors of satisfaction, including treatment success, baseline disability, and demographic factors.
Main Results:
- The PDI-expectancy questionnaire demonstrated a robust one-factor structure.
- Correlations between expected disability and baseline measures were low.
- Treatment success showed a low correlation with satisfaction (χ=0.13; P<0.01), contributing minimally to overall satisfaction.
Conclusions:
- The PDI-expectancy is a psychometrically sound measure.
- Pretreatment expectations have a small but unique impact on satisfaction.
- Patients achieving treatment success were 1.38 to 4.24 times more likely to be satisfied; notably, 51.4% reported satisfaction regardless of treatment success.
