Patients' needs in low back pain management

14-02-2018
This review, aimed at optimal treatment of low back pain (LBP), gives us insight into the fact that patients actively participate in care, made possible by positive interactions with their healthcare provider(s) (HCP). To achieve such results, a good understanding of the patient's perspective (patient empowerment) with regard to their HCP is necessary. For this reason, it is necessary to review the existing literature on the patient-perceived needs of HCP that manage LBP.

A systematic scoping assessment was carried out with the help of publications in MEDLINE, EMBASE, CINAHL and PsycINFO (1990-2016). With regard to the design and methodology of the study, descriptive data were extracted and the risk of bias was assessed. Aggregates were categorized for the perceived needs of HCP patients for LBP. This assessment was carried out within a larger project that examined the needs for the musculoskeletal health of the observed patients. A systematic scoping assessment has been conducted on the framework proposed in view of the breadth of the subject and to allow extensive exploration and identification of the patient's perspective. Systematic scoping evaluations are focused on identifying key concepts, identifying gaps in current literature and assessing different types of evidence.

43 Studies (30 qualitative, 12 quantitative and 1 mixed methods) relevant. Four areas of perceived needs emerged: (1) Good communication and shared decision-making are different characteristics of HCP that patients desire. (2) Patients indicated a need for information provided by HCP, including a cause of their LBP and legitimation of their symptoms. (3) The valued comprehensive, individualized care of patients and the continuity of care. (4) Patients experience problems with access to treatment, long waiting times, costs and personal efforts as obstacles to care.

Patients with LBP are actively involved, need patient-centered care and have identified features of HCP that promote a good relationship between provider and patient. The desire for patient-centered care can be described by the need for good communication skills. In addition to the fact that patients prefer a clear explanation of their treatment or diagnosis, they indicated a great need for patient participation and open communication. Patients also indicated that they wanted to be taken seriously by their HCP and preferred a caregiver who showed understanding, concern and compassion by listening, offering emotionally supportive communication and showing respect. They also prefer cooperation and shared decision-making in their care plan, want to be clear about their diagnosis and the cause of the pain they experience.

In addition to discovering dissatisfaction with HCP, they also experience obstacles to care. HCP and policy makers need to implement new delivery methods that address these issues to improve patient satisfaction and enable better results for both patient and healthcare, given the limited healthcare resources.

Physical Therapy Science

Low Back Pain

Physical Therapy

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