Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations
Objective This study aimed to explore the perceptions of orthopaedic clinicians about consultations for people with persistent musculoskeletal low back pain (PMLBP) in which surgery is not recommended. Surgery is not recommended for the majority of PMLBP consulting in secondary care settings.Setting...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-09-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/9/e052938.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850180812697239552 |
|---|---|
| author | Philip Sell Alison H McGregor Tamar Pincus Lisa Roberts Kathrin Louise Braeuninger-Weimer Naffis Anjarwalla |
| author_facet | Philip Sell Alison H McGregor Tamar Pincus Lisa Roberts Kathrin Louise Braeuninger-Weimer Naffis Anjarwalla |
| author_sort | Philip Sell |
| collection | DOAJ |
| description | Objective This study aimed to explore the perceptions of orthopaedic clinicians about consultations for people with persistent musculoskeletal low back pain (PMLBP) in which surgery is not recommended. Surgery is not recommended for the majority of PMLBP consulting in secondary care settings.Setting Secondary care sector in the UK.Participants Semi-structured qualitative interviews were conducted with 24 orthopaedic team clinicians from 17 different hospitals in the UK and Ireland. Interviews explored clinicians’ perceptions of the challenges in consultations where surgery is not indicated. Interviews were transcribed verbatim and analysed using thematic analysis.Results Two meta-themes, Difficulties and Enablers, each consisting of several subthemes were identified. Difficulties included challenges around the choice of appropriate terminology and labels for PMLBP, managing patients’ expectations, working with mentally vulnerable patients and explaining imaging findings. Enablers included early management of expectations, use of routine imaging, triaging, access to direct referral elsewhere, including other non-surgical practitioners in the team, training to improve communication skills and understanding of psychological issues.Conclusion The findings highlight clinicians’ perceived need for concordance in messages delivered across the care pathway and training of orthopaedic clinicians to deliver effective reassurance and address patients’ needs in circumstances where surgery is not indicated. |
| format | Article |
| id | doaj-art-69d0cb2267624c919f0b4eee725ba2e6 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-69d0cb2267624c919f0b4eee725ba2e62025-08-20T02:18:03ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2021-052938Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultationsPhilip Sell0Alison H McGregor1Tamar Pincus2Lisa Roberts3Kathrin Louise Braeuninger-Weimer4Naffis Anjarwalla5Department of Orthopaedics, Leicester University Hospitals, Leicester, UKMSk Lab, Faculty of Medicine, Imperial College London, London, UKDepartment of Psychology, University of London, London, UKprofessorPsychology, Royal Holloway University of London, Egham, UKOrthopaedic, Wexham Park Hospital, Slough, UKObjective This study aimed to explore the perceptions of orthopaedic clinicians about consultations for people with persistent musculoskeletal low back pain (PMLBP) in which surgery is not recommended. Surgery is not recommended for the majority of PMLBP consulting in secondary care settings.Setting Secondary care sector in the UK.Participants Semi-structured qualitative interviews were conducted with 24 orthopaedic team clinicians from 17 different hospitals in the UK and Ireland. Interviews explored clinicians’ perceptions of the challenges in consultations where surgery is not indicated. Interviews were transcribed verbatim and analysed using thematic analysis.Results Two meta-themes, Difficulties and Enablers, each consisting of several subthemes were identified. Difficulties included challenges around the choice of appropriate terminology and labels for PMLBP, managing patients’ expectations, working with mentally vulnerable patients and explaining imaging findings. Enablers included early management of expectations, use of routine imaging, triaging, access to direct referral elsewhere, including other non-surgical practitioners in the team, training to improve communication skills and understanding of psychological issues.Conclusion The findings highlight clinicians’ perceived need for concordance in messages delivered across the care pathway and training of orthopaedic clinicians to deliver effective reassurance and address patients’ needs in circumstances where surgery is not indicated.https://bmjopen.bmj.com/content/11/9/e052938.full |
| spellingShingle | Philip Sell Alison H McGregor Tamar Pincus Lisa Roberts Kathrin Louise Braeuninger-Weimer Naffis Anjarwalla Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations BMJ Open |
| title | Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations |
| title_full | Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations |
| title_fullStr | Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations |
| title_full_unstemmed | Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations |
| title_short | Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians’ perceptions of persistent low back pain consultations |
| title_sort | taking patients to the ice cream shop but telling them that they cannot have ice cream a qualitative study of orthopaedic spine clinicians perceptions of persistent low back pain consultations |
| url | https://bmjopen.bmj.com/content/11/9/e052938.full |
| work_keys_str_mv | AT philipsell takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations AT alisonhmcgregor takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations AT tamarpincus takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations AT lisaroberts takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations AT kathrinlouisebraeuningerweimer takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations AT naffisanjarwalla takingpatientstotheicecreamshopbuttellingthemthattheycannothaveicecreamaqualitativestudyoforthopaedicspinecliniciansperceptionsofpersistentlowbackpainconsultations |