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BMC Musculoskeletal Disorders

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Open Access 01-12-2017 | Research article

Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study

Authors: Sigrid Skatteboe, Cecilie Røe, Morten Wang Fagerland, Lars-Petter Granan

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Abstract

Background

Research has suggested that patient expectations are associated with treatment outcome and evolve along with patient communication within the musculoskeletal field. However, few studies have investigated if or how physical medicine and rehabilitation (PMR) consultations affect the attending patients’ expectations regarding pain and functional improvement. Hence, the aims of the present study were to compare patient expectations regarding pain and functional improvement before and after a PMR consultation and to assess patient characteristics, including diagnosis, that could perhaps predict changes in expectations.

Methods

The study design was cross-sectional. Eligible participants were first-time patients with neck/back or shoulder complaints who were referred to a PMR outpatient clinic between January and June 2013. Questionnaires (the Patient Shoulder Outcome Expectancies, or PSOE, questionnaire and a numeric rating scale, or NRS) focused on expectations regarding pain and functioning were completed immediately prior to and after a consultation with a PMR specialist.

Results

In total, 257 patients were included. In total, 24% of the subjects expected a more positive outcome after the PMR consultation compared with before the consultation, while 10% of the subjects exhibited a negative change in expectations. Few patient characteristics other than sick leave were associated with changes in expectations; however, patients with shoulder complaints seemed to be more optimistic than patients with neck/back complaints.

Conclusion

Expectations can be influenced by a single specialist consultation. Among clinical prognostic factors, only sick leave influenced the change expectations. However, patients with shoulder complaints seemed to be more optimistic than patients with neck/back complaints.

Trial registration

The study was approved by the Data Protection Office at Oslo University Hospital, 2012/2574. ISRCTN registration: 40963362 (registered retrospectively 12.12.2016)

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Rotter JB. Some implications of a social learning theory for the prediction of goal directed behavior from testing procedures. Psychol Rev. 1960;67:301–16.CrossRefPubMed

Lurie JD, Berven SH, Gibson-Chambers J, Tosteson T, Tosteson A, Hu SS, Weinstein JN. Patient preferences and expectations for care: determinants in patients with lumbar intervertebral disc herniation. Spine. 2008;33(24):2663–8.CrossRefPubMedPubMedCentral

Haanstra TM, Hanson L, Evans R, van Nes FA, De Vet HC, Cuijpers P, Ostelo RW. How do low back pain patients conceptualize their expectations regarding treatment? Content analysis of interviews. Eur Spine J. 2013;22(9):1986–95.CrossRefPubMedPubMedCentral

Ozegovic D, Carroll LJ, David Cassidy J. Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study. Eur Spine J. 2009;18(6):893–9.CrossRefPubMedPubMedCentral

Janzen JA, Silvius J, Jacobs S, Slaughter S, Dalziel W, Drummond N. What is a health expectation? Developing a pragmatic conceptual model from psychological theory. Health Expect. 2006;9(1):37–48.CrossRefPubMedPubMedCentral

Kapoor S, Shaw WS, Pransky G, Patterson W. Initial patient and clinician expectations of return to work after acute onset of work-related low back pain. J Occup Environ Med. 2006;48(11):1173–80.CrossRefPubMed

Goldstein MS, Morgenstern H, Hurwitz EL, Yu F. The impact of treatment confidence on pain and related disability among patients with low-back pain: results from the University of California, Los Angeles, low-back pain study. Spine J. 2002;2(6):391–9. discussion 399–401.CrossRefPubMed

O’Malley KJ, Roddey TS, Gartsman GM, Cook KF. Outcome expectancies, functional outcomes, and expectancy fulfillment for patients with shoulder problems. Med Care. 2004;42(2):139–46.CrossRefPubMed

Foster NE, Bishop A, Thomas E, Main C, Horne R, Weinman J, Hay E. Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome? Pain. 2008;136(1–2):177–87.CrossRefPubMed

10.

Bishop MD, Mintken PE, Bialosky JE, Cleland JA. Patient expectations of benefit from interventions for neck pain and resulting influence on outcomes. J Orthop Sports Phys Ther. 2013;43(7):457–65.CrossRefPubMedPubMedCentral

11.

Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes. CMAJ. 2001;165(2):174–9.PubMedPubMedCentral

12.

Iles RA, Davidson M, Taylor NF, O’Halloran P. Systematic review of the ability of recovery expectations to predict outcomes in non-chronic non-specific low back pain. J Occup Rehabil. 2009;19(1):25–40.CrossRefPubMed

13.

Myers SS, Phillips RS, Davis RB, Cherkin DC, Legedza A, Kaptchuk TJ, Hrbek A, Buring JE, Post D, Connelly MT, et al. Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med. 2008;23(2):148–53.CrossRefPubMed

14.

Goossens ME, Vlaeyen JW, Hidding A, Kole-Snijders A, Evers SM. Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain. Clin J Pain. 2005;21(1):18–26. discussion 69–72.CrossRefPubMed

15.

Mancuso CA, Graziano S, Briskie LM, Peterson MG, Pellicci PM, Salvati EA, Sculco TP. Randomized trials to modify patients’ preoperative expectations of hip and knee arthroplasties. Clin Orthop Relat Res. 2008;466(2):424–31.CrossRefPubMedPubMedCentral

16.

Bialosky JE, Bishop MD, Cleland JA. Individual expectation: an overlooked, but pertinent, factor in the treatment of individuals experiencing musculoskeletal pain. Phys Ther. 2010;90(9):1345–55.CrossRefPubMedPubMedCentral

17.

Di Blasi Z, Harkness E, Ernst E, Georgiou A, Kleijnen J. Influence of context effects on health outcomes: a systematic review. Lancet. 2001;357(9258):757–62.CrossRefPubMed

18.

Britten N, Stevenson FA, Barry CA, Barber N, Bradley CP. Misunderstandings in prescribing decisions in general practice: qualitative study. BMJ. 2000;320(7233):484–8.CrossRefPubMedPubMedCentral

19.

Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality care. Inquiry. 1988;25(1):25–36.PubMed

20.

Hoffmann TC, Del Mar CB, Strong J, Mai J. Patients’ expectations of acute low back pain management: implications for evidence uptake. BMC Fam Pract. 2013;14:7.CrossRefPubMedPubMedCentral

21.

Baker SC, Gallois C, Driedger SM, Santesso N. Communication accommodation and managing musculoskeletal disorders: doctors’ and patients’ perspectives. Health Commun. 2011;26(4):379–88.CrossRefPubMed

22.

Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013;11(6):527–34.CrossRefPubMedPubMedCentral

23.

Skatteboe S, Roe C, Fagerland MW, Granan LP. Expectations for treatment outcomes in neck/back patients regarding improvements in pain and function: A cross-sectional pilot study. Eur J Phys Rehabil Med. 2014;50:649–56.

24.

Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974;19(1):1–15.CrossRefPubMed

25.

Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003;57(2):113–8.CrossRefPubMed

26.

Nunnaly J. Psychometric theory. New York: McGraw Hill; 1978.

27.

Kamaleri Y, Natvig B, Ihlebaek CM, Benth JS, Bruusgaard D. Number of pain sites is associated with demographic, lifestyle, and health-related factors in the general population. Eur J Pain. 2008;12(6):742–8.CrossRefPubMed

28.

Stuart A. A test for the homogeneity of the marginal distributions in a two-way classification. 1955.

29.

Green SB. How many subjects does it take to do a regression analysis. Multivariate Behav Res. 1991;26(3):499–510.CrossRefPubMed

30.

Boonstra AM, Reneman MF, Stewart RE, Schiphorst Preuper HR. Do male and female patients with chronic musculoskeletal pain differ in their pre-treatment expectations of rehabilitation outcome? J Rehabil Med. 2011;43(1):65–9.CrossRefPubMed

31.

Hopayian K, Notley C. A systematic review of low back pain and sciatica patients’ expectations and experiences of health care. Spine J. 2014;14(8):1769–80.CrossRefPubMed

32.

Georgy EE, Carr EC, Breen AC. Back pain management in primary care: development and validity of the Patients’ and Doctors’ Expectations Questionnaire. Qual Prim Care. 2013;21(2):113–22.PubMed

33.

Sanderson KB, Roditi D, George SZ, Atchison JW, Banou E, Robinson ME. Investigating patient expectations and treatment outcome in a chronic low back pain population. J Pain Res. 2012;5:15–22.PubMedPubMedCentral

34.

Vasseljen O, Woodhouse A, Bjorngaard JH, Leivseth L. Natural course of acute neck and low back pain in the general population: the HUNT study. Pain. 2013;154(8):1237–44.CrossRefPubMed

35.

Reme SE, Hagen EM, Eriksen HR. Expectations, perceptions, and physiotherapy predict prolonged sick leave in subacute low back pain. BMC Musculoskelet Disord. 2009;10:139.CrossRefPubMedPubMedCentral

36.

Kongsted A, Vach W, Axo M, Bech RN, Hestbaek L. Expectation of recovery from low back pain: a longitudinal cohort study investigating patient characteristics related to expectations and the association between expectations and 3-month outcome. Spine (Phila Pa 1976). 2014;39(1):81–90.CrossRef

37.

Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Phila Pa 1976). 2002;27(5):E109–120.CrossRef

38.

van Hartingsveld F, Ostelo RW, Cuijpers P, de Vos R, Riphagen II, de Vet HC. Treatment-related and patient-related expectations of patients with musculoskeletal disorders: a systematic review of published measurement tools. Clin J Pain. 2010;26(6):470–88.CrossRefPubMed

Title: Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study
Authors: Sigrid Skatteboe
Cecilie Røe
Morten Wang Fagerland
Lars-Petter Granan
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-016-1386-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study

Abstract

Background

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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