Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: a cross-sectional study

Autor: Holt, Nicola; Pincus, Tamar
Sprache: Englisch
Veröffentlicht: 2016
Quelle: BioMed Central
Online Zugang: http://www.biomedcentral.com/1471-2474/17/277
http://www.biomedcentral.com/1471-2474/17/277
Erfassungsnummer: ftbiomed:oai:biomedcentral.com:s12891-016-1144-2

Zusammenfassung

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 ...