title: Clinician-patient agreement about the work disability problem of patients having persistent pain: why it matters.
abstract: BACKGROUND
  Studies from different fields documenting the differences between clinicians' and workers' representations have not elucidated where the differences exist or how they can be resolved.
  
  
  OBJECTIVE
  To define and describe scenarios depicting the differences between clinical judgment, workers' representations about their disability and clinicians' interpretations of these representations.
  
  
  METHODS
  A multiple case-study design was used. Semi-structured prospective interviews were conducted at four points in time, with five clinicians managing 12 cases of workers having persistent pain and participating in an evidence-based work rehabilitation program.
  
  
  RESULTS
  Four scenarios depicting differences in representations were found, but not all the differences necessarily had a negative impact on the program outcomes. For the clinicians, clear identification of the problem was important to allow for the use of concrete, pragmatic strategies. For the workers, congruence between the proposed strategy and their representations was crucial.
  
  
  CONCLUSIONS
  During rehabilitation, the objectives must be acceptable to both parties or the proposed strategy must, at least, make sense to the patient.
authors.affiliation: Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada. Marie-France.Coutu@USherbrooke.ca
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Coutu
authors.forename: Raymond
authors.initials: R
authors.lastname: Baril
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Durand
authors.forename: Daniel
authors.initials: D
authors.lastname: Côté
authors.forename: Geneviève
authors.initials: G
authors.lastname: Cadieux
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000534:rehabilitation; D004185:Disability Evaluation; D034462:Dissent and Disputes; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000534:rehabilitation; D009790:Occupations; D059408:Pain Management; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011446:Prospective Studies; D062707:Return to Work