title: Reasons for drop-out in rehabilitation treatment of native patients and non-native patients with chronic low back pain in the Netherlands: a medical file study.
abstract: OBJECTIVE
  Drop-out of rehabilitation treatment in non-native patients with chronic low back pain has been reported to be higher than in native Dutch patients. It was expected that drop-out in non-native patients would be due to different expectations on the content of rehabilitation treatment and due to language or communication problems. Aim of this study was to determine differences in reasons for drop-out between native patients and non-native patients with chronic non-specific low back pain participating in a rehabilitation program.
  
  
  METHODS
  A retrospective study in medical files (N.=99) of patients who dropped out of treatment was performed in two rehabilitation centers and two rehabilitation departments of general hospitals. Patient files were checked for diagnosis, status of origin, gender, age and reason for drop-out. The differences in frequency in reasons for drop-out between native and non-native patients were tested by Chi-square tests.
  
  
  RESULTS
  Withdrawal due to different expectations on the content of rehabilitation treatment occurred significantly more frequently in non-native patients (P=0.035). Withdrawal due to refusal to participate (no further reason given) occurred more often (P=0.008) in native Dutch patients than in non-native patients. No significant differences between non-native patients and native Dutch patients were reported regarding withdrawal due to language or communication problems, and no show (patient did not show up at consultation sessions without informing about the reason and without making an appointment for a new consultation).
  
  
  CONCLUSIONS
  The present study provided evidence that drop-out in non-native patients is often related to different expectations regarding the content of rehabilitation treatment.
authors.affiliation: Jan van Breemen Institute, Center for Rheumatology and Rehabilitation, Amsterdam, The Netherlands. m.sloots@janvanbreemen.nl
authors.forename: M
authors.initials: M
authors.lastname: Sloots
authors.forename: J H M
authors.initials: JH
authors.lastname: Dekker
authors.forename: E A C
authors.initials: EA
authors.lastname: Bartels
authors.forename: J H B
authors.initials: JH
authors.lastname: Geertzen
authors.forename: J
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003144:Communication Barriers; D004522:Educational Status; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000208:ethnology; D010352:Patient Dropouts / Q000523:psychology*; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D013532:Suriname / Q000208:ethnology; D011795:Surveys and Questionnaires; D014421:Turkey / Q000208:ethnology