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The patient–physician relationship in patients with chronic low back pain as a predictor of outcomes after rehabilitation

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Abstract

For patients with chronic diseases, especially those with chronic low back pain, the patient–physician relationship is significant for treatment adherence. In a sample of N = 688 low back pain patients, we examined the hypothesis that aspects of the patient–physician relationship (e.g. satisfaction with care, trust in the physician, patient participation) have a significant association with outcomes (pain, disability, quality of life, pain-related psychological impairment) after a multimodal treatment program (rehabilitation) after adjusting for a number of sociodemographic, medical, and psychological factors. Results show that the patient–physician relationship is significantly associated with the outcome. In the medium term (6 months after rehabilitation), the effect of the patient–physician relationship is clearer than in the short term (end of rehabilitation). In addition, risk factors for less improvement are female gender, higher age, low income, comorbidity, low treatment motivation, fear avoidance beliefs, and external locus of control. Future studies should examine the causal paths between the relationship variables and the outcome variables.

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Acknowledgments

The study was conducted in the project “patient–provider communication for chronically ill patients: gender- and age-specific preferences of patients”, which is funded in Germany by the Federal Ministry of Education and Research (grant no.: 01 GX 0740) as part of the funding priority for “Chronic Illnesses and Patient Orientation” (http://www.forschung-patientenorientierung.de). Ms. Desiree Kosiol was part of the project team for long phases of the project. We would like to thank her for her extremely competent and helpful contribution. We wish to thank the cooperating rehabilitation centers for their support in data collection: Eisenmoorbad Bad Schmiedeberg (Bad Schmiedeberg), Fachklinikum Brandis (Brandis), Klinik Niederbayern (Bad Füssing), Salztalklinik (Bad Soden-Salmünster), Ambulante Reha-Klinik Sanaris (Passau), Ambulantes Reha Centrum (Schweinfurt), Ambulantes Rehazentrum Wöhrder-wiese (Nürnberg), Gesundheitszentrum am Lutherhaus (Essen), REGIO-Reha (Freiburg), REHA-Tagesklinik im Forum Pankow (Berlin), Gesundheitszentrum Chiemgau (Traunstein).

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  1. Department of Quality Management and Social Medicine, University Medical Center Freiburg, Engelbergerstr. 21, 79106, Freiburg, Germany

    Erik Farin, Lukas Gramm & Erika Schmidt

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  1. Erik Farin
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Correspondence to Erik Farin.

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Farin, E., Gramm, L. & Schmidt, E. The patient–physician relationship in patients with chronic low back pain as a predictor of outcomes after rehabilitation. J Behav Med 36, 246–258 (2013). https://doi.org/10.1007/s10865-012-9419-z

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