• Kongsted A
• Christensen MR
• Ingersen KK
• Secher Jensen T

• Affiliation / Aarhus University. Department of Clinical Medicine
• Affiliation / Silkeborg Regional Hospital. University Research Clinic for Innovative Patient Pathways. Diagnostic Centre
• Affiliation / University of Southern Denmark. Department of Sports Science and Clinical Biomechanics
• Affiliation / University of Southern Denmark. Nordic Institute of Chiropractic and Clinical Biomechanics
• Affiliation(G) / Denmark / Aarhus
• Affiliation(G) / Denmark / Odense
• Affiliation(G) / Denmark / Silkeborg
• Back Pain / diagnosis
• Chiropractic / Denmark
• Open Access Document
• Primary Health Care
• Professional-Patient Relations
• Referral and Consultation
• Surveys and Questionnaires

Background: Reassuring information is recommended in clinical guidelines for the treatment of low back pain (LBP), but has not been clearly defined. The Consultation-based Reassurance Questionnaire (CRQ) was developed as a tool for measuring to what extent reassurance is present in back pain consultations and may provide important information about the clinical encounter. Until now the CRQ has only been tested in general practice patients in the UK although many patients with LBP are seen outside of this setting. The objectives of this study were to translate the CRQ into Danish, test its feasibility in chiropractic practice, and determine if CRQ scores were associated with satisfaction with care and perceived pain control.

Methods: On the day of the first visit for a LBP episode, patients received an electronic survey including the CRQ. Distributions and completeness of responses on the four subscales of the CRQ (data-gathering, relationship-building, generic reassurance, cognitive reassurance) were assessed, and internal consistency for each subscale calculated as Cronbach’s alpha. Outcomes at 2 weeks were; satisfaction with care (5-point Likert scale dichotomised into yes/no) and ability to control pain (0–10). Associations of the CRQ with patient characteristics and outcomes were determined in mixed models to account for dependency of observations within clinics.

Results: From 964 patients visiting between November 2016 and October 2017 with new episodes of LBP, 717 completed the CRQ with no more than 1% missing values on any single item. The internal consistency was acceptable for all subscales (0.67–0.86). Scores were generally high, and more so in patients visiting a chiropractor for the first time. All four subscales were positively associated with satisfaction (Odds ratios 1.08–1.23) and generic reassurance was weakly associated with pain control (β = 0.07 [95% CI 0.03–0.11]).

Conclusions: The CRQ was feasible for use in a Danish chiropractic setting and scores on all four reassurance subscales related positively to patients’ satisfaction. Patients who had visited a chiropractor previously reported slightly lower levels of reassuring information, and it should be explored if this is in accordance with the patients’ needs. The potential impact on patient outcomes needs investigation.

Author keywords: Back pain — Chiropractic — Patient involvement — Primary health care — Questionnaires — Reassurance

Author affiliations: AK, TSJ: Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark; AK, MRC, KKI: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; TSJ: Diagnostic Imaging, Silkeborg Regional Hospital, Silkeborg, Denmark; TSJ: Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record