DOCTORS’ ATTITUDES AND BELIEFS TO PATIENTS WITH CHRONIC LOW BACK PAIN: A QUALITATIVE STUDY

Abstract

Background: General practitioners (GPs), orthopaedic surgeons, rheumatologists and pain consultants manage the majority of patients with chronic low back pain (CLBP) in primary and secondary care settings in the Republic of Ireland. Little is known about their attitudes and beliefs to CLBP, although the existing literature highlights a range of factors influencing such beliefs including: past experience, education, time and resources¹. This study aimed to investigate factors influencing attitudes and beliefs of Irish doctors to the management of CLBP patients.

Method: A multiple case studies design of semi-structured audiotaped interviews (30 minutes) was conducted on a purposeful sample of GPs (n=7) and Consultants (n=7: orthopaedic surgeons, n=2; Pain consultants, n=2; Rheumatologists n=2 Neurosurgeon, n=1) in July 2006. Questions were devised based on the results of a systematic review of the literature of the topic. All interviews were subsequently transcribed, coded and a cross case analysis was constructed. Approval was obtained from the UCD Human Research Ethics Committee.

Results: The main emerging themes included Doctors current holistic management (referral for physical and mental health treatment), the negative impact of lack of resources on treatment options (lack of multidisciplinary services and prolonged waiting times for Consultant appointments), the influence of the medicolegal system on patients (increased stress) and Doctors (increased referral rates for investigations and procedures).

Conclusion: Doctors’ attitudes and beliefs regarding CLBP management may have important influences on both patient outcomes and resource utilization within the health service. These findings will inform a national postal survey of Doctors attitudes to CLBP.