A review of secondary healthcare provision for civilians suffering persistent pain and living in the British Forces Germany (BFG) community was carried out in order to better inform referral from primary care. This population consists mostly of British nationals each with differing linguistic skills and cultural backgrounds. Patients may be referred to Evangelisches Krankenhaus Bielefeld (EvKB) in Germany or to Guys and St Thomas' NHS Foundation Trust (GSTT) in the UK. It was considered important to identify potential language or cultural-related barriers to improve decision making when considering where best to refer for a pain management programme (PMP). Clinical visits undertaken at GSTT and EvKB involved observation of clinical activities, collection of documentation and informal staff discussions. Data were organised into common themes and categorised to provide information for written reflective accounts on each visit.Purpose and background
Methods
Low back pain is a common condition amongst Armed Services personnel and can have significant impact upon their ability to undertake military duties, including being deployed into austere environments. This was a qualitative study of 16 military physiotherapists exploring their attitudes and beliefs towards management of low back pain. Semi-structured interviews were conducted and transcribed. The transcripts were analysed using a method of thematic content analysis. Six themes were identified; military culture, occupational issues, continuing professional development, clinical reasoning, need for a cure and labelling the patient. The highly challenging occupational demands placed on military patients appeared to prompt physiotherapists to request radiological investigations at an earlier stage than recommended in current guidelines. Justification for early investigation was considered to be both in the patients' and the Armed Services best interests, for the patient to initiate treatment with minimum delay whilst also decreasing the number of personnel unable to deploy for medical reasons.Background
Methods and results
