Patient Characteristics Are Associated With Differences in Perceptions of Reassurance After a Consultation for Low Back Pain: Analysis of an Observational Study in Primary Care

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-08-05 DOI:10.1002/ejp.70098

Anika Young, Adrian C. Traeger, Simon D. French, Alice Kongsted, Mark J. Hancock, Tue S. Jensen, Hazel J. Jenkins

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Abstract

Background

People with low back pain (LBP) report different perceptions of reassurance after a consultation. We aimed to determine whether patient characteristics are associated with differences in patient perceptions of reassurance.

Methods

Secondary analysis of 2048 adults presenting with back pain to a chiropractor. We used linear mixed models to determine associations between patient sociodemographic, clinical and psychological characteristics and the outcome of reassurance measured using the four subscales of the Consultation-based Reassurance Questionnaire (CRQ).

Results

Patients with higher perceived risk of pain persistence reported perceiving less reassurance in their consultation, on all four subscales of the CRQ: data-gathering (regression co-efficient −0.13 [99% confidence interval: −0.23, −0.03]), relationship-building (−0.13 [−0.22, −0.04]), cognitive reassurance (−0.20 [−0.30, −0.10]) and generic reassurance (−0.27 [−0.39, −0.15]). Older age was associated with lower cognitive reassurance (−0.03 [−0.05, −0.01]) and generic reassurance (−0.04 [−0.07, −0.02]). Males were associated with lower relationship-building scores (0.70 [−1.13 to −0.28]), compared to females. Previous spinal imaging was associated with lower generic reassurance (−0.68 [−1.28, −0.09]). Compared to acute pain, higher levels of reassurance were perceived by patients with subacute pain [data-gathering (0.83 [0.10, 1.65]), relationship-building (0.70 [0.02, 1.37]), cognitive reassurance (0.87 [0.11, 1.56])]. Higher back pain intensity was associated with higher levels of relationship-building (0.13 [0.01, 0.25]) and generic reassurance (0.18 [0.02, 0.34]).

Conclusion

People with higher perceived risk of pain persistence, previous spinal imaging, male and older age perceived slightly lower levels of reassurance. The impact of these associations on the success of a LBP consultation is unclear.

Significance Statement

People seeking care for LBP report receiving variable levels of reassurance from healthcare providers. It is unknown whether perceived reassurance may differ according to patient characteristics. We identified several patient characteristics associated with lower perceived reassurance during a consultation for LBP, including higher perceived risk of pain persistence, previous imaging for LBP, males, older age, acute pain and lower LBP intensity. Knowledge of these characteristics may help inform optimal delivery of individualised patient reassurance.

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患者特征与腰痛咨询后对安心的感知差异相关：一项初级保健观察性研究分析

背景：患有腰痛（LBP）的人在咨询后对安慰的看法不同。我们的目的是确定患者特征是否与患者对安慰的感知差异有关。方法对2048例向脊医就诊的成人背痛患者进行二次分析。我们使用线性混合模型来确定患者社会人口学，临床和心理特征与使用基于咨询的保证问卷（CRQ）的四个子量表测量的保证结果之间的关系。结果：在CRQ的所有四个子量表中，感知疼痛持续风险较高的患者报告在咨询中感受到的安慰较少：数据收集（回归系数为- 0.13[99%置信区间：- 0.23,- 0.03]），关系建立（- 0.13[- 0.22,- 0.04]），认知安慰（- 0.20[- 0.30,- 0.10]）和一般安慰（- 0.27[- 0.39,- 0.15]）。年龄越大，认知安心度（- 0.03[- 0.05,- 0.01]）和一般安心度（- 0.04[- 0.07,- 0.02]）越低。与女性相比，男性的关系建立得分较低（0.70[- 1.13至- 0.28]）。既往脊柱影像学与较低的一般安心度相关（- 0.68[- 1.28,- 0.09]）。与急性疼痛相比，亚急性疼痛患者的安心水平更高[数据收集（0.83[0.10,1.65]），关系建立（0.70[0.02,1.37]），认知安心（0.87[0.11,1.56]）]。较高的背部疼痛强度与较高水平的人际关系建立（0.13[0.01,0.25]）和一般安慰（0.18[0.02,0.34]）相关。结论疼痛持续风险感知较高、既往脊柱影像学、男性和年龄较大的患者的安心程度略低。这些关联对LBP咨询成功的影响尚不清楚。寻求LBP治疗的人报告从医疗保健提供者那里得到不同程度的保证。目前尚不清楚感知到的安慰是否会根据患者的特点而有所不同。我们确定了几个与LBP咨询期间较低的感知安心度相关的患者特征，包括较高的感知疼痛持续风险、既往LBP影像学、男性、老年、急性疼痛和较低的LBP强度。了解这些特征可能有助于告知个性化患者保证的最佳交付。

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

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.