title: The clinical and cultural factors in classifying low back pain patients within Greece: a qualitative exploration of Greek health professionals.
abstract: OBJECTIVE
  Identifying homogenous subgroups of low back pain (LBP) patients is considered a priority in musculoskeletal rehabilitation and is believed to enhance clinical outcomes. In order to achieve this, the specific features of each subgroup need to be identified. The aim of this study was to develop a list of clinical and cultural features that are included in the assessment of LBP patients in Greece, among health professionals. This 'list' will be, utilized in a clinical study for developing LBP subgroups.
  
  
  METHODS
  Three focus groups were conducted, each one comprising health professionals with homogenous characteristics and all coordinated by a single moderator. There were: 11 physiotherapists (PTs) with clinical experience in LBP patients, seven PTs specialized in LBP management, and five doctors with a particular spinal interest. The focus of discussions was to develop a list of clinical and cultural features that were important in the examination of LBP. Content analysis was performed by two researchers.
  
  
  RESULTS
  Clinicians and postgraduates developed five categories within the History (Present Symptoms, History of Symptoms, Function, Psychosocial, Medical History) and six categories within the Physical Examination (Observation, Neurological Examination, Active and Passive Movements, Muscle Features and Palpation). The doctors identified four categories in History (Symptomatology, Function, Psychosocial, Medical History) and an additional in Physical Examination (Special Tests). All groups identified three cultural categories; Attitudes of Health Professionals, Patients' Attitudes and Health System influences.
  
  
  CONCLUSIONS
  An extensive Greek 'list' of clinical and cultural features was developed from the groups' analysis. Although similarities existed in most categories, there were several differences across the three focus groups which will be discussed.
authors.affiliation: Department of Physiotherapy, Axhool of Health and Caring Professions, Technological Education Institute of Lamia, Lamia, Greece. billis@teilam.gr
authors.forename: Evdokia V
authors.initials: EV
authors.lastname: Billis
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McCarthy
authors.forename: Ioannis
authors.initials: I
authors.lastname: Stathopoulos
authors.forename: Eleni
authors.initials: E
authors.lastname: Kapreli
authors.forename: Paulina
authors.initials: P
authors.lastname: Pantzou
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Oldham
mesh_terms: D001291:Attitude of Health Personnel; D003469:Culture; D005260:Female; D017144:Focus Groups; D006115:Greece; D006282:Health Personnel; D006801:Humans; D017116:Low Back Pain / Q000145:classification*; D008297:Male; D017060:Patient Satisfaction; D010808:Physical Examination