title: The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.
abstract: OBJECTIVE
  To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI).
  
  
  METHODS
  Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain.
  
  
  RESULTS
  Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain.
  
  
  CONCLUSIONS
  This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Boelelaan 1089A, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Carlijn H
authors.initials: CH
authors.lastname: van Randeraad-van der Zee
authors.affiliation: Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands.|Department of Family Practice, Caphri, Maastricht University, Maastricht, The Netherlands.
authors.forename: Anna J H M
authors.initials: AJ
authors.lastname: Beurskens
authors.affiliation: Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands.|Department of Physical Therapy, Zuyd University of Applied Sciences, Heerlen, The Netherlands.
authors.forename: Raymond A H M
authors.initials: RA
authors.lastname: Swinkels
authors.affiliation: Research Center for Innovations in Healthcare, University of Applied Science Utrecht, Utrecht, The Netherlands.
authors.forename: Jan J M
authors.initials: JJ
authors.lastname: Pool
authors.affiliation: Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Australia.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Batterham
authors.affiliation: Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Australia.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Osborne
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Boelelaan 1089A, 1081 HV, Amsterdam, The Netherlands. hcw.devet@vumc.nl.
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D006282:Health Personnel; D006801:Humans; D019547:Neck Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Burden of neck pain; Cluster analysis; Concept mapping; Content validity; Mind map; Multidimensional scaling; Patient-reported outcomes