272 Comparing Clinical And Lay Accounts Of The Diagnosis And Treatment Of Back Pain.

Author(s): 
Bie Nio Ong, Helen Hooper and Peter Croft
Primary Care Sciences Research Centre,
Keele University,
Keele ST5 5BG.
Text: 
Introduction/research question
This paper extends the analysis of clinician-patient communication by directly comparing patient and professional accounts of diagnosis, treatment and outcomes over time. Comparisons are made between and within lay and clinical perspectives.
Method The research is part of the Back pain Research in North Staffordshire (BaRNS) Study. This is a longitudinal study looking at pain, disability and health care use in a consecutive cohort of LBP consulters from primary care, using qualitative and quantitative methods. This paper is based upon a narrative analysis of two clusters. First, one patient who established concordant relationships with the four health professionals who treated her back pain; second, one patient who had both concordant and discordant relationships with health professionals.
Results Therapeutic relationships between health professionals and patients are determined by interpersonal and contextual factors. Concordance is important in creating positive relationships, but it also has a 'downside: professionals respond to patient demands leading to the possible over-use of health care.
Discussion/Conclusion
The context within which therapeutic relationships develop warrants closer scrutiny because this determines the type of care that is accessed. In order to understand how effective therapeutic relationships are established a comparative analysis of the perceptions of all stakeholders is essential, and their accounts have to be given meaning within context.
Literature: 
272 COMPARING CLINICAL AND LAY ACCOUNTS OF THE DIAGNOSIS AND TREATMENT OF BACK PAIN.