"Doctor-Led, Patient-Centered": A Mixed-Method Research Comparing Patients' and Doctors' Treatment Outcome Choices for Chronic Low Back Pain.

IF 2 3区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Patient preference and adherence Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S501409
Xia Li, Ying Zhang, Zhuxin Mao, Qianji Chen, Xiaoxue Lan, Hong Chen, Ya-Nan Sun, Chang-He Yu, Xi-You Wang
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引用次数: 0

Abstract

Background: Chronic low back pain (CLBP) significantly impacts quality of life. Treatment outcomes are influenced by the perspectives and expectations of both patients and doctors, making it crucial to understand these views to optimize care and satisfaction.

Purpose: This study aims to analyze the alignment and differences in doctors' and patients' perceptions of treatment outcomes and explore the implications of these differences.

Methods: An explanatory sequential mixed-methods design was used, involving a questionnaire survey and two focus groups. The study was conducted at Dongzhimen Hospital from August 2020 to January 2021. Participants, including patients with any type of CLBP (age≥18) and doctors with at least one year of experience, were selected via purposive sampling. Quantitative data, analyzed with SPSS, were summarized as percentages for categorical variables and as means with standard deviations or medians for continuous variables. Differences between variables were assessed using the Chi-square and nonparametric rank sum tests. Focus group discussions were analyzed thematically to explore differing perspectives on treatment outcomes.

Results: A questionnaire gathered perspectives from 30 patients (mean age 45±11.74 years) and 26 doctors (mean age 41.7±6.7 years). The results informed the development of specific questions for focus group interviews with 8 patients and 8 doctors. Quantitative results revealed that pain/discomfort and activities of daily living were equally important to both groups. However, many outcomes were valued differently. Five themes emerged: 1) Doctors' focus on treating the whole person; 2) Patients' emphasis on cost-effectiveness/satisfaction; 3) Patients' prioritization of body image and physical function; 4) Shared priority beyond pain; 5) Shared concerns on adverse events.

Conclusion: This study highlights the importance of aligning treatment expectations between patients and doctors to improve satisfaction and outcomes in CLBP management. Enhanced communication strategies and shared decision-making are recommended to bridge these gaps.

“医生主导,患者为中心”:一项混合方法研究,比较慢性腰痛患者和医生的治疗结果选择。
背景:慢性腰痛(CLBP)显著影响生活质量。治疗结果受到患者和医生的观点和期望的影响,因此了解这些观点对于优化护理和满意度至关重要。目的:本研究旨在分析医生和患者对治疗结果认知的一致性和差异,并探讨这些差异的含义。方法:采用解释性顺序混合方法设计,包括问卷调查和两个焦点小组。该研究于2020年8月至2021年1月在东直门医院进行。参与者,包括任何类型的CLBP患者(年龄≥18岁)和至少有一年经验的医生,通过有目的的抽样选择。定量数据用SPSS进行分析,分类变量用百分比表示,连续变量用标准差或中位数表示。使用卡方检验和非参数秩和检验评估变量之间的差异。对焦点小组讨论进行主题分析,以探讨对治疗结果的不同观点。结果:问卷调查收集了30名患者(平均年龄45±11.74岁)和26名医生(平均年龄41.7±6.7岁)的观点。研究结果为对8名患者和8名医生进行焦点小组访谈的具体问题的制定提供了信息。定量结果显示,疼痛/不适和日常生活活动对两组同样重要。然而,许多结果的价值是不同的。出现了五个主题:1)医生注重治疗整个人;2)患者对成本效益/满意度的重视;3)患者对身体形象和身体功能的优先级;4)超越痛苦的共同优先;5)共同关注不良事件。结论:本研究强调了调整患者和医生之间的治疗期望对于提高CLBP管理的满意度和结果的重要性。建议加强沟通战略和共同决策,以弥合这些差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Patient preference and adherence
Patient preference and adherence MEDICINE, GENERAL & INTERNAL-
CiteScore
3.60
自引率
4.50%
发文量
354
审稿时长
6-12 weeks
期刊介绍: Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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