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Predictors of communication preferences in patients with chronic low back pain

机译：慢性下腰痛患者的沟通偏好预测因素

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Background: The objective of this exploratory study was to identify patient-related predictors of communication preferences in patients with chronic low back pain for various dimensions of patient-physician communication (patient participation and orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances).Methods: Eleven rehabilitation centers from various parts of Germany participated in collection of data between 2009 and 2011. A total of 701 patients with chronic low back pain were surveyed at the start of rehabilitation. The patient questionnaire captured communication preferences, pain impact, pain intensity, and psychologic variables (fear avoidance beliefs, illness coherence, control beliefs, communication self-efficacy, and personality characteristics). The rehabilitation physicians filled out a documentation sheet containing information on diagnosis, inability to work, duration of the illness, and comorbidity at the beginning and end of rehabilitation. Hierarchical regression analyses were performed.Results: On average, effective, open, and patient-centered communication was very important for patients with back pain, emotionally supportive communication was important, and communication about personal circumstances was somewhat important. The variance in communication preferences explained by the predictors studied here was 8%–19%. Older patients showed a lower preference for patient-centered and open communication, but a higher preference for communication about personal circumstances. Patients with psychologic risk factors (eg, fear avoidance beliefs), extroverted patients, and patients with high self-efficacy in patient-physician interaction generally had higher expectations of the physician's communicative behavior.Conclusion: Providers should take into consideration the fact that patients with back pain have a strong need for effective, open, and patient-centered communication. A flexible approach to communication needs appears to be especially important for communication about emotional and personal circumstances, because the patients differ most clearly in this respect. Personal characteristics provided only initial clues to possible preferences; for more precision, an individual assessment (by means of questionnaires or discussion) is needed.
机译：背景：本探索性研究的目的是针对慢性腰背痛患者，从医患沟通的各个方面（患者参与和方向，有效和开放的沟通，情感支持性沟通，方法：2009年至2011年间，德国不同地区的11个康复中心参加了数据收集。康复开始时，共对701名慢性下腰痛患者进行了调查。患者调查表记录了沟通偏好，疼痛影响，疼痛强度和心理变量（避免恐惧的信念，疾病的连贯性，控制信念，沟通的自我效能和人格特征）。康复医师填写了一份文档表，其中包含有关诊断，无法工作，疾病持续时间以及康复开始和结束时合并症的信息。结果：平均而言，有效，开放和以患者为中心的沟通对于背痛患者非常重要，情感支持沟通很重要，而关于个人情况的沟通也很重要。在这里研究的预测变量解释的沟通偏好差异为8％–19％。老年患者对以患者为中心的开放式沟通偏爱，但对个人情况的沟通偏爱。具有心理风险因素（例如避免恐惧的信念）的患者，性格外向的患者以及在患者与医生互动中具有较高自我效能的患者通常对医生的沟通行为抱有更高的期望。结论：提供者应考虑以下事实：背痛非常需要有效，开放和以患者为中心的沟通。对于患者情绪和个人情况的交流，灵活的交流需求方法显得尤为重要，因为患者在这方面的差异最为明显。个人特征仅提供了可能偏好的初步线索;为了更精确，需要进行个人评估（通过问卷或讨论的方式）。

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