How do low back pain patients conceptualize their expectations regarding treatment? Content analysis of interviews

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • T. M. Haanstra
  • L. Hanson
  • R. Evans
  • F. van Nes
  • H. de Vet
  • Pim Cuijpers
  • R. W. J. G. Ostelo
Purpose
The purpose of this study was to gain insight into how low back pain (LBP) patients conceptualize the construct of expectations regarding treatment.
Methods
This study was nested within a mixed-method randomized clinical trial comparing three primary care interventions for LBP. A total of 77 participants with LBP lasting longer than 6 weeks were included; semi-structured interviews were conducted querying patients about their expectations for treatment. Also factors influencing their expectations were explored. Interviews were administered following enrollment into the study, but prior to study treatment. Two researchers independently conducted a content analysis using NVIVO 9 software.
Results
LBP patients’ expectations could be categorized in two main domains: outcome and process expectations, each with subdomains. Patients expressed expectations in all subdomains both as values (what they hoped) and probabilities (what they thought was likely). In multiple subdomains, there were differences in the nature (positive vs. negative) and frequency of value and probability expectations. Participants reported that multiple factors influenced their expectations of which past experience with treatment appeared to be of major influence on probability expectations.
Conclusion and recommendations
This study showed that LBP patients’ expectations for treatment are multifaceted. Current measurement instruments do not cover all domains and subdomains of expectations. Therefore, we recommend the development of new or improved measures that make a distinction between value and probability expectations and assess process and/or outcome expectations covering multiple subdomains. Some of the influencing factors found in this study may be useful targets for altering patients’ treatment expectations and improving health outcomes.
Original languageEnglish
JournalEuropean Spine Journal
Volume22
Issue number9
Pages (from-to)1986-1995
Number of pages10
ISSN0940-6719
DOIs
Publication statusPublished - 09.2013

    Research areas

  • Health sciences - Patients expectation, low back pain, qualitive research, Psychological factors, Patient preference

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