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The challenge of using the low back pain guidelines: a qualitative research
Author(s) -
Dahan Rachel,
Borkan Jeffry,
Brown JudithBell,
Reis Shmuel,
Hermoni Doron,
Harris Stewart
Publication year - 2007
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2007.00855.x
Subject(s) - focus group , qualitative research , context (archaeology) , medicine , low back pain , perspective (graphical) , nursing , guideline , medical education , family medicine , psychology , alternative medicine , pathology , paleontology , social science , marketing , artificial intelligence , sociology , computer science , business , biology
Purpose Current low back pain (LBP) clinical guidelines have helped to summarize the scientific evidence and research, but have failed to provide tools and guide family physicians (FPs). The purpose of this study is to identify barriers and facilitators for the implementation of LBP guidelines from family FPs’ perspective. Methods A qualitative focus group study of FPs in the north of Israel. Purposeful sampling was used to recruit participants, all of them board‐certified FPs. Four focus groups were created, and discussions were taped, transcribed and analysed for major themes. Results Focus groups findings have expanded the understanding of the intellectual and mental challenges faced by Israeli FPs caring for LBP patients and highlighted the many obstacles to implementing LBP guidelines. Physicians’ decision‐making, pertaining to LBP, functions on three levels simultaneously: the physicians’ agenda based on familiarity with the guidelines; their need to remain grounded in the context of the specific patient–doctor relationship; and the constraints and demands of the physician’s workplace, medical system and environment. Conclusions Despite an overall positive attitude towards LBP guideline implementation, FPs found it hard to come to terms with the conflicting dimensions of LBP patient care. The patient–doctor interaction determined the outcome of the encounter, whether it complied with the guidelines and whether the encounter leads to a healing process or to a vicious circle of unnecessary utilization of services.