Article Figures & Data
Tables
- Table 1.
Pearson Correlations of Patient and Provider Communication with Pain and Function Outcomes
Verbal Exchanges Pain Rating Functional Limitation First Visit (n = 90) At 1 Month (n = 80) At 3 Months (n = 77) At 1 Month (n = 80) At 3 Months (n = 77) Provider Biomedical/therapeutic questions 0.16 0.41† 0.27* 0.31† 0.35† Lifestyle/psychosocial questions 0.03 0.34† 0.16 0.30† 0.30† Biomedical/therapeutic information 0.17 0.06 0.03 0.08 0.08 Lifestyle/psychosocial information 0.15 −0.08 −0.06 −0.09 −0.02 Facilitation/engagement 0.14 0.50† 0.43† 0.40† 0.46† Rapport building Positive 0.11 0.31† 0.27* 0.32† 0.31† Negative 0.19 0.20 0.17 0.21 −0.13 Emotional 0.01 −0.05 −0.06 0.15 0.23* Socializing/chit-chat −0.20 0.00 −0.06 −0.05 −0.03 Procedural language 0.16 0.34* 0.19 0.15 0.21 Patient Biomedical/therapeutic questions 0.08 −0.06 −0.01 −0.12 −0.02 Lifestyle/psychosocial questions 0.18 0.06 0.00 0.10 −0.03 Biomedical/therapeutic information 0.02 0.43† 0.29† 0.22* 0.30† Lifestyle/psychosocial information 0.00 0.09 0.13 0.13 0.20 Facilitation/engagement 0.01 -0.01 0.05 0.05 0.00 Rapport building Positive 0.10 0.20 0.19 0.03 0.10 Negative 0.10 0.04 0.23* 0.17 0.23* Emotional −0.27* 0.26* 0.26* 0.21 0.24* Socializing/chit-chat −0.20 -0.08 −0.11 -0.10 −0.10 Procedural language 0.06 0.25* 0.25* 0.02 0.24* * P < .05.
† P < .01.
- Table 2.
A Representative Sampling of Psychosocial and Lifestyle Questions Asked by Clinicians during Recorded Visits
Domain Question RIAS Code Worries or concerns Any other concerns or anything? Psychosocial, open-ended Emotional state How do you feel about that? Psychosocial, open-ended Why were you upset with yourself? Psychosocial, open-ended Workplace barriers What's happening with work? Lifestyle, open-ended Have you talked to them about this? Lifestyle, closed-ended Health habits Drink a lot of alcohol? Lifestyle, closed-ended Exercise regimen Did you do the exercises? Daily? Lifestyle, closed-ended (2) Self-care Are these inserts in your shoes? Lifestyle, closed-ended Work status Have you been working or out of work totally? Lifestyle, closed-ended Work habits You know you don’t have to work long shifts, right? Lifestyle, closed-ended Injury factors Shoveling or just the snowplow? Lifestyle, closed-ended Recreation What kind of sports do you play? Lifestyle, open-ended Job modification Did Mr. M. say you’re not able to work at all? Lifestyle, closed-ended If I bumped you to 25 lb, would that change the work you can do? Lifestyle, closed-ended Workplace exposures Do you do a lot of that kneeling and crawling in your work? Lifestyle, closed-ended Daily activities Are you back in your bed? Lifestyle, closed-ended Job description What kind of animals do you raise? Lifestyle, closed-ended Lifting technique Are you lifting them with good body mechanics? Lifestyle, closed-ended Daily activities Have you been raising your daughter by yourself? Lifestyle, closed-ended Have you traveled recently? Lifestyle, closed-ended RAIS, Roter Interaction Analysis System.
- Table 3.
Comparison of Initial Patient-Provider Communication to 3-Month Return-to-Work and Case Ratings
Verbal Exchanges Return to Work* Statistic Clinical Case Rating Statistic Returned (n = 54) (mean [SD]) Not returned (n = 23) (mean [SD]) Remitted (n = 47) (mean [SD]) Unresolved (n = 30) (mean [SD]) Biomedical/therapeutic questions Provider 32.35 (19.06) 51.35 (27.97) t(75) = 2.98† 32.23 (19.10) 47.10 (27.20) t(75) = 2.82† Patient 1.93 (3.15) 2.35 (2.69) NS 2.00 (3.35) 2.13 (2.43) NS Lifestyle/psychosocial questions Provider 6.24 (4.08) 8.65 (6.41) NS 6.30 (4.28) 8.00 (5.82) NS Patient 0.81 (1.12) 0.61 (0.78) NS 0.75 (0.99) 0.77 (1.10) NS Biomedical/therapeutic information Provider 53.11 (40.03) 49.17 (27.26) NS 52.14 (41.98) 51.60 (26.55) NS Patient 63.56 (29.65) 90.04 (45.62) t(75) = 3.03† 63.00 (31.01) 84.73 (41.87) t(75) = 2.61† Lifestyle/psychosocial information Provider 28.02 (22.67) 20.70 (15.00) NS 27.66 (23.31) 22.97 (16.24) NS Patient 25.78 (26.09) 33.35 (27.30) NS 26.15 (26.89) 31.00 (26.08) NS Facilitation/engagement Provider 30.02 (14.71) 46.91 (21.28) t(75) = 4.01† 27.68 (12.03) 46.63 (21.01) t(75) = 4.49† Patient 2.07 (2.74) 2.43 (2.48) NS 2.13 (2.88) 2.27 (2.30) NS Positive rapport building Provider 37.17 (18.41) 46.30 (19.49) t(75) = 1.96† 36.28 (17.16) 45.57 (20.79) t(75) = 2.13† Patient 35.20 (19.88) 37.17 (19.88) NS 34.85 (20.33) 37.27 (19.10) NS Negative rapport building Provider 0.35 (0.78) 0.17 (0.39) NS 0.38 (0.82) 0.17 (0.38) NS Patient 0.41 (0.94) 1.57 (3.38) t(75) = 2.33† 0.34 (0.92) 1.40 (3.00) NS Emotional rapport building Provider 18.54 (11.56) 20.22 (14.38) NS 17.23 (11.00) 21.87 (14.05) NS Patient 9.89 (9.03) 13.57 (11.43) NS 9.49 (9.23) 13.33 (10.55) NS Socializing/chit-chat Provider 1.91 (3.71) 1.74 (3.51) NS 0.38 (0.82) 0.17 (0.38) NS Patient 1.52 (3.86) 0.96 (2.18) NS 0.34 (0.92) 1.40 (3.00) NS Procedural language Provider 32.85 (16.37) 47.78 (28.30) t(75) = 2.91† 0.38 (0.82) 0.17 (0.38) NS Patient 0.57 (1.09) 2.17 (2.72) t(75) = 3.70† 0.34 (0.92) 1.40 (3.00) NS * Resumption of normal, full-duty responsibilities.
† P < .05
NS, not significant.
- Table 4.
Open-Ended Questions to Elicit Patient Information about Psychosocial and Workplace Factors
Psychosocial Domain Recommended Open-Ended Interview Questions Physical job demands Are you concerned about resuming any particular job tasks? Ease of job modification Do you think your work might be modified to ease your transition back to work? Job stress Is that a stressful type of work? Workplace social support How do you think your supervisor and co-workers will react? Return-to-work expectations Any other concerns about returning to work? Fear of reinjury Why do you think you have the pain? Are you worried about more serious injury? Job commitment and tenure Have you been doing this type of work for long? Fear avoidance beliefs Do you have any fears about your pain? What do you fear the most? Pain catastrophizing What does your pain mean for your body? Depressed mood Any history of mood problems? High distress/anger How are you managing with the pain? Why do you think you have the pain? Low self-efficacy What are the best ways that you cope with pain? Symptom expectations How severe is your pain? How long do you think it will last? Pain behavior/lifestyle What are the biggest problems that your pain will cause for you?
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