Twenty-eight articles met the inclusion criteria. Most studies were of high quality.
Nine themes emerged: the process and content of care, relationships and interpersonal skills, personalized
care, information, the outcome of care, the importance of a diagnosis, delegitimation,
recognizing the expert, and service matters. How care was given mattered greatly to patients, with
importance given to receiving a perceived full assessment, consideration for the individual’s context,
good relationships, empathy, and the sharing of information. These aspects of care facilitated
the acceptance by some of the limitations of health care and were spread across disciplines. Not
having a diagnosis made coping more difficult for some but for others led to delegitimation, a
feeling of not being believed. Service matters such as cost and waiting time received little
mention.
CONCLUSIONS: Although much research into the development of chronic low back pain (LBP)
has focused on the patient, this review suggests that research into aspects of care also warrant research.
The benefits of generic principles of care, such as personalization and communication, are
important to patients with LBP and sciatica; so, practitioners may help their patients by paying as
much attention to them as to specific interventions. When neither cure nor a diagnostic label is
forthcoming, generic skills remain important for patient satisfaction. 2014 Elsevier Inc. All
rights reserved.
Twenty-eight articles met the inclusion criteria. Most studies were of high quality.Nine themes emerged: the process and content of care, relationships and interpersonal skills, personalizedcare, information, the outcome of care, the importance of a diagnosis, delegitimation,recognizing the expert, and service matters. How care was given mattered greatly to patients, withimportance given to receiving a perceived full assessment, consideration for the individual’s context,good relationships, empathy, and the sharing of information. These aspects of care facilitatedthe acceptance by some of the limitations of health care and were spread across disciplines. Nothaving a diagnosis made coping more difficult for some but for others led to delegitimation, afeeling of not being believed. Service matters such as cost and waiting time received littlemention.CONCLUSIONS: Although much research into the development of chronic low back pain (LBP)has focused on the patient, this review suggests that research into aspects of care also warrant research.The benefits of generic principles of care, such as personalization and communication, areimportant to patients with LBP and sciatica; so, practitioners may help their patients by paying asmuch attention to them as to specific interventions. When neither cure nor a diagnostic label isforthcoming, generic skills remain important for patient satisfaction. 2014 Elsevier Inc. Allrights reserved.
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