Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: a cross-sectional study
Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: a cross-sectional study
Background: Reassurance from physicians is commonly recommended in guidelines for the management of low back pain (LBP), but the process of reassurance and its impact on patients is poorly researched. We aimed to develop a valid and reliable measure of the process of reassurance during LBP consultations. Methods: Items representing the data-gathering stage of the consultation and affective and cognitive reassurance were generated from literature on physician-patient communication and piloted with expert researchers and physicians, a Patient and Public Involvement group, and LBP patients to form a questionnaire. Patients presenting for LBP at 43 General Practice surgeries were sent the questionnaire. The questionnaire was analysed with Rasch modelling, using two samples from the same population of recent LBP consultations: the first (n = 157, follow-up n = 84) for exploratory analysis and the second (n = 162, follow-up n = 74) for confirmatory testing. Responses to the questionnaire were compared with responses to satisfaction and enablement scales to assess the external validity of the items, and participants completed the questionnaire again one-week later to assess test-retest reliability. Results: The questionnaire was separated into four subscales: data-gathering, relationship-building, generic reassurance, and cognitive reassurance, each containing three items. All subscales showed good validity within the Rasch models, and good reliability based on person- and item-separations and test-retest reliability. All four subscales were significantly positively correlated with satisfaction and enablement for both samples. The final version of the questionnaire is presented here. Conclusions: Overall, the measure has demonstrated a good level of validity and generally acceptable reliability. This is the first measure to focus specifically on reassurance for LBP in primary care settings, and will enable researchers to further understanding of what is reassuring within the context of low back pain consultations, and how outcomes are affected by different types of reassurance. Additionally, the measure may provide a useful training and audit tool for physicians. The new measure requires testing in prospective cohorts, and would benefit from further validation against ethnographic observation of consultations in real time.
1-15
Holt, Nicola
8a89923e-93a8-426c-bdcd-107691549b48
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
12 July 2016
Holt, Nicola
8a89923e-93a8-426c-bdcd-107691549b48
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Holt, Nicola and Pincus, Tamar
(2016)
Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: a cross-sectional study.
BMC Musculoskeletal Disorders, 17, , [277].
(doi:10.1186/s12891-016-1144-2).
Abstract
Background: Reassurance from physicians is commonly recommended in guidelines for the management of low back pain (LBP), but the process of reassurance and its impact on patients is poorly researched. We aimed to develop a valid and reliable measure of the process of reassurance during LBP consultations. Methods: Items representing the data-gathering stage of the consultation and affective and cognitive reassurance were generated from literature on physician-patient communication and piloted with expert researchers and physicians, a Patient and Public Involvement group, and LBP patients to form a questionnaire. Patients presenting for LBP at 43 General Practice surgeries were sent the questionnaire. The questionnaire was analysed with Rasch modelling, using two samples from the same population of recent LBP consultations: the first (n = 157, follow-up n = 84) for exploratory analysis and the second (n = 162, follow-up n = 74) for confirmatory testing. Responses to the questionnaire were compared with responses to satisfaction and enablement scales to assess the external validity of the items, and participants completed the questionnaire again one-week later to assess test-retest reliability. Results: The questionnaire was separated into four subscales: data-gathering, relationship-building, generic reassurance, and cognitive reassurance, each containing three items. All subscales showed good validity within the Rasch models, and good reliability based on person- and item-separations and test-retest reliability. All four subscales were significantly positively correlated with satisfaction and enablement for both samples. The final version of the questionnaire is presented here. Conclusions: Overall, the measure has demonstrated a good level of validity and generally acceptable reliability. This is the first measure to focus specifically on reassurance for LBP in primary care settings, and will enable researchers to further understanding of what is reassuring within the context of low back pain consultations, and how outcomes are affected by different types of reassurance. Additionally, the measure may provide a useful training and audit tool for physicians. The new measure requires testing in prospective cohorts, and would benefit from further validation against ethnographic observation of consultations in real time.
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Accepted/In Press date: 23 June 2016
Published date: 12 July 2016
Additional Information:
M1 - 277
NH was supported by a studentship from the Economic and Social Research Council’s Doctoral Training Centre.
This study was supported by a EUROSpine grant.
Identifiers
Local EPrints ID: 469253
URI: http://eprints.soton.ac.uk/id/eprint/469253
ISSN: 1471-2474
PURE UUID: 42a5aec3-0ce0-487c-b970-436cdebacf79
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Date deposited: 09 Sep 2022 17:03
Last modified: 17 Mar 2024 04:11
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Author:
Nicola Holt
Author:
Tamar Pincus
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