title: First rehabilitation consultation in patients of non-native origin: factors that lead to tension in the patient-physician interaction.
abstract: OBJECTIVE
  To explore which factors lead to tension in the patient-physician interaction in the first consultation by rehabilitation physicians of patients with chronic non-specific low back pain of Turkish and Moroccan origin.
  
  
  METHODS
  In-depth semi-structured, face to face interviews were conducted with 12 patients of Moroccan and Turkish origin and four native Dutch rehabilitation physicians. Interviews were transcribed and/or summarised. All interviews were subsequently coded and analysed according to themes.
  
  
  RESULTS
  Factors that lead to tension in the patient-physician interaction were as follows: differences in expectations regarding the aim of treatment, symptom presentation, views on responsibilities with regard to rehabilitation treatment, lack of trust, contradicting views of physicians from patients' country of origin with regard to the cause and treatment of pain and communication problems.
  
  
  CONCLUSIONS
  Sources of tension were identified during the interaction between Dutch physicians and patients of Turkish and Moroccan origin. These factors potentially are associated with future drop-out. Future research should clarify whether these factors indeed are associated with drop-out.
authors.affiliation: Department of Research and Education, Jan van Breemen Institute, Centre for Rheumatology and Rehabilitation, Amsterdam, The Netherlands. m.sloots@janvanbreemen.nl
authors.forename: M
authors.initials: M
authors.lastname: Sloots
authors.forename: E F
authors.initials: EF
authors.lastname: Scheppers
authors.forename: E A C
authors.initials: EA
authors.lastname: Bartels
authors.forename: J H M
authors.initials: JH
authors.lastname: Dekker
authors.forename: J H B
authors.initials: JH
authors.lastname: Geertzen
authors.forename: J
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D003469:Culture; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009426:Netherlands; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D013315:Stress, Psychological; D035502:Trust; D014421:Turkey / Q000208:ethnology; D055815:Young Adult