None listed
Conditions
Brief summary
This observational study takes place within Orthopaedic Spinal Clinics where staff consist of Physiotherapists and Medical Officers. The majority of patients are not likely to benefit from surgery. Instead, patients are offered reassurance regarding their spinal condition and advice to promote non-surgical strategies such as a graded activity plan. There is evidence linking reassurance to patient satisfaction and condition management however limited evidence that Physiotherapists and medical officers can equally reassure patents following an assessment in Orthopaedic spinal clinics. The primary aim of this pilot study is to evaluate the level of reassurance reported by patients via the Consultation Based Reassurance questionnaire (CRQ) following exposure to either the Physiotherapist or medical officer model of care in an Orthopaedic Spinal Clinic. Secondary outcomes of interest include pain, functional limitations and confidence managing pain symptoms. Outcomes are assessed at baseline, 1 day following clinic and 3 months following clinic.
Interventions
a) Exposure/Intervention
This study will be undertaken within the orthopaedic spinal clinic (OSC) at John Hunter Hospital, a tertiary referral hospital in New South Wales, Australia. The focus of the OSC is to evaluate and determine whether surgery may be helpful for a person’s spinal condition. Following assessment in the OSC patients may be recommended surgery or non-surgical options for their spinal condition such as injection therapies, physical rehabilitation and lifestyle interventions suc
a) Exposure/Intervention This study will be undertaken within the orthopaedic spinal clinic (OSC) at John Hunter Hospital, a tertiary referral hospital in New South Wales, Australia. The focus of the OSC is to evaluate and determine whether surgery may be helpful for a person’s spinal condition. Following assessment in the OSC patients may be recommended surgery or non-surgical options for their spinal condition such as injection therapies, physical rehabilitation and lifestyle interventions such as smoking cessation or dietitian advice. The focus of this study will be with adult patients referred for back and/or neck pain (Including Radicular/Radiculopathy). These patients will be assessed by either Medical officers or Physiotherapists who discuss each case with the consultant in charge to establish clinic recommendations for ongoing care. The medical officer or Physiotherapist is then responsible for discussing the clinic outcome and recommendations to each patient and communicating the outcome to the patient's referrer. This evaluation will focus on any patient that is able to undertake non-surgical care recommendations for at least 3 months following the clinic appointment. b) Data collection. Participants will complete: Consultation-based re- assurance questionnaire (CRQ) (Holt & Pincus, 2016) Patient-Reported Outcomes Measurement Information System (PROMIS)-29 Pain self-efficacy questionnaire Tampa Scale of Kinesiophobia – 11 (TSK-11) Global Rating of Change Scale (GROC) Additional questions include - educational level, employment status, recent health expenditure. Clinicians will complete: Physiotherapists and medical officers will complete a clinic outcome/survey form with each participant. questions include time taken for consultation, diagnosis, education delivered. This takes 1-3minutes to complete c) Time taken to complete questionnaires A consumer who had previously attended the clinic was consulted on the questionnaires. The complete set took up to 15minutes to complete. d) Participants will complete questionnaires at baseline, 1 day after the OSC clinic appointment and 90days (3 months) following the clinic appointment.
Sponsors
John Hunter Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants over 18 years of age presenting for care in orthopaedic spinal Clinics at JHH during the research period. Referred for back pain with or without leg pain or neck pain with or without arm pain. Able to provide consent Able to undertake non-surgical care for at least 3 months following the clinic appointment.
Exclusion criteria
Cognitive impairment limiting ability to understand or follow recommendations. Unable to read or speak English and does not have interpreter service support. Unable to undertake recommended conservative care. Reasons may include terminal disease, spinal tumor, fracture identified, active spinal infection Assessed as needing urgent (Less than 3 months) surgery.
Outcome results
None listed