Abstract
Purpose and background
Pain related distress is associated with poor low back pain outcomes, and is challenging for practitioners to address. This study investigated osteopaths' beliefs about the relationship between chronic pain (CP) and distress (D). The research aimed to explore how patient's distress is understood and managed by osteopath educator clinicians with an interest in the field.
Methods and results
A qualitative research design using a constructivist grounded theory analytical approach was used to analyse semi-structured interviews. A purposive sample of seven osteopaths working at the British School of Osteopathy (BSO) with experience with CP-D was recruited. Data collection and analysis were carried out simultaneously. Audio-recording, verbatim-transcriptions, memos-writing and diary-keeping were used to develop themes and theory.
Three main themes were identified: osteopaths understanding of the CP-D presentation, evaluation and assessment of the CP-D patient, the role of the osteopath and therapist-patient interaction in CP-D treatment. Three sub-themes were developed for each theme.
Conclusions
Osteopaths recognized the relationship between CP-D. They considered the management of this presentation complex and challenging due to extensive clinical uncertainty. Osteopaths considered the therapist-patient interaction as a crucial vehicle for evaluating the individual patient presentation along with understanding patient's biopsychosocial factors and readiness to change, however a lack of rigor was identified with this process. Challenges related to evaluation were mainly related to patient characteristics and osteopath's lack of training. Further work is required to develop better evaluation and intervention strategies as well as understanding patient's attitudes to the relationship between CP and D.
Conflict of interest: None
Sources of funding: None
