title: The effects of patient-provider communication on 3-month recovery from acute low back pain.
abstract: BACKGROUND
  patient-provider communication has been indicated as a key factor in early recovery from acute low back pain (LBP), one of the most common maladies seen in primary care; however, associations between communication and LBP outcomes have not been studied prospectively.
  
  
  METHODS
  working adults (n = 97; 64% men; median age, 38 years) with acute LBP completed baseline surveys, agreed to audio recording of provider visits, and were followed for 3 months. Using the Roter Interaction Analysis System, 10 composite indices of communication were compared with 1- and 3-month patient outcomes.
  
  
  RESULTS
  patients (n = 30) with significant pain and dysfunction persisting at 3 months provided more biomedical information (t[75], 2.61; P < .05) and engaged in more negative rapport building (t[75], 2.33; P < .05) but showed no increase in psychosocial/lifestyle communication during the initial visit (P > .05). Providers asked these patients more biomedical questions (r = 0.35 with dysfunction), more psychosocial/lifestyle questions (r = 0.30), made more efforts to engage the patient (t[75], 4.49; P < .05), and did more positive rapport building (t[75], 2.13; P < .05).
  
  
  CONCLUSIONS
  providers adapt their communication patterns to collect more information and establish greater rapport with high-risk patients, but patients focus more on biomedical than coping concerns. To better elicit psychosocial concerns from patients, providers may need to administer brief self-report measures or adopt more structured interviewing techniques.
authors.affiliation: Liberty Mutual Research Institute for Safety, Center for Disability Research, Hopkinton, MA 01748, USA. william.shaw@libertymutual.com
authors.forename: William S
authors.initials: WS
authors.lastname: Shaw
authors.forename: Glenn
authors.initials: G
authors.lastname: Pransky
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Thomas
authors.initials: T
authors.lastname: Winters
authors.forename: Torill H
authors.initials: TH
authors.lastname: Tveito
authors.forename: Susan M
authors.initials: SM
authors.lastname: Larson
mesh_terms: D000208:Acute Disease; D000328:Adult; D003142:Communication; D004185:Disability Evaluation; D005260:Female; D019538:Health Care Surveys; D006305:Health Status Indicators; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D018570:Risk Assessment; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013637:Tape Recording; D013997:Time Factors; D016896:Treatment Outcome