Word Choice Influences Patient Perception of Prognosis

Degenerative explanations of back pain may have a negative impact
By Monica Smith
HealthDay Reporter

MONDAY, Oct. 11 (HealthDay News) -- The way clinicians explain a patient's back pain may influence the patient's perceived prognosis and uptake of therapy; sticking with language used in radiology reports may be more helpful than using degenerative terms, such as "wear and tear," according to research published in the Oct. 1 issue of Spine.

Tim John Sloan, and David Andrew Walsh, Ph.D., of the Sherwood Forest Hospitals NHS Foundation Trust in the United Kingdom, analyzed patient interviews, correspondence from clinicians, and radiology reports for patients with more than 12 months of chronic low back pain to examine the language patients and health care professionals use to describe this pain and what effect this may have on patient perceived prognosis.

The researchers identified two major categories that represented predominant themes: degeneration and mechanical. The former, including terms like "wear and tear" and "disc space loss," was associated with a progressive breakdown of structural integrity and, when used by patients, with a poor perceived prognosis. Both mechanical and degenerative terms were used more often by patients when they were documented in correspondence from secondary care specialists. The authors write that explaining radiological findings to patients may challenge unhelpful beliefs and facilitate uptake of treatment strategies.

The research "suggests that patients, at least in part, derive their beliefs and explanations for their pain from their clinicians. Health care professionals interpret radiology reports to patients, and this interpretation may be expected to have a more important effect on the patients' understanding, and their perceived prognosis, than the written content of the report itself," the authors write.

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