Christoph A Stueckle1,2,3, Benedikt Hackert4, Sarah Talarczyk5,6, Martin Wawro4, Patrick Haage5,7, Ulrich Weger4. 1. Faculty of Health, Witten/Herdecke University, Witten, Germany. c.stueckle@radiologie-do.de. 2. Department of Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany. c.stueckle@radiologie-do.de. 3. MVZ Professor Uhlenbrock Und Partner GmbH, Dortmund, Germany. c.stueckle@radiologie-do.de. 4. Department of Psychology, Faculty of Health, Witten/Herdecke University, Witten, Germany. 5. Faculty of Health, Witten/Herdecke University, Witten, Germany. 6. MVZ Professor Uhlenbrock Und Partner GmbH, Dortmund, Germany. 7. Department of Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany.
Abstract
BACKGROUND: Back pain is a common problem and a burden for the patient. MR-morphologically proven pain-causing changes of the spine is often successfully treated utilizing CT-guided pain therapy. The CT-guided execution enables a controlled and reproducible therapy. Nevertheless, treatment results can differ even with the same patient; the physician is a possible influencing factor of the outcome. Accordingly, the present study analyzes the different behaviors and forms of communication of the treating physicians during the course of the intervention as factors influencing the outcome of treatment. METHODS: 67 patients suffering from specific back pain were included in this study. 5 treating physicians (2 female, 3 male) of different age (29-63 years), and experience and a total of 244 CT-guided treatments were included in this study. In every case a psychologist observed the treatment based on a standardized observation protocol. Observed were both the verbal and non-verbal interactions as well as the reaction of patient and physician. The success of the therapy was measured in the course of the treatment using the visual analogue pain scale. The technical comparability of the performed CT-guided periradicular therapy was ensured by the distribution of the drug mixture. RESULTS: The outcome is significantly better if the patient considers the treating physician to be competent (correlation coefficient: 0.24, p < 0.006) and feels understood (correlation coefficient: 0.29, p < 0.001). In addition, the outcome is better when the physician believes that the treatment brings a positive reduction of pain, underlining his belief with positive statements of affirmation before the intervention thus creating a positive atmosphere [correlation coefficient: 0.24 (p < 0.009)]. In contrast, the outcome is worse if the patient complains about pain during the intervention [average pain reduction M = 0.9 (pain group) vs. M = 2.0 (no-pain group)]. CONCLUSION: Our study shows that with comparable implementation of CT-guided periradicular therapy, the outcome of the patient with specific back pain can be significantly improved by certain behavioral patterns of the performing physician and this without side effects and without significant additional time expenditure. Our findings indicate that there is a non-negligible psychological factor linking confidence in therapy to actual therapy success. TRIAL REGISTRATION: The study was designed as an observational study, therefore a trial registration was not necessary.
BACKGROUND: Back pain is a common problem and a burden for the patient. MR-morphologically proven pain-causing changes of the spine is often successfully treated utilizing CT-guided pain therapy. The CT-guided execution enables a controlled and reproducible therapy. Nevertheless, treatment results can differ even with the same patient; the physician is a possible influencing factor of the outcome. Accordingly, the present study analyzes the different behaviors and forms of communication of the treating physicians during the course of the intervention as factors influencing the outcome of treatment. METHODS: 67 patients suffering from specific back pain were included in this study. 5 treating physicians (2 female, 3 male) of different age (29-63 years), and experience and a total of 244 CT-guided treatments were included in this study. In every case a psychologist observed the treatment based on a standardized observation protocol. Observed were both the verbal and non-verbal interactions as well as the reaction of patient and physician. The success of the therapy was measured in the course of the treatment using the visual analogue pain scale. The technical comparability of the performed CT-guided periradicular therapy was ensured by the distribution of the drug mixture. RESULTS: The outcome is significantly better if the patient considers the treating physician to be competent (correlation coefficient: 0.24, p < 0.006) and feels understood (correlation coefficient: 0.29, p < 0.001). In addition, the outcome is better when the physician believes that the treatment brings a positive reduction of pain, underlining his belief with positive statements of affirmation before the intervention thus creating a positive atmosphere [correlation coefficient: 0.24 (p < 0.009)]. In contrast, the outcome is worse if the patient complains about pain during the intervention [average pain reduction M = 0.9 (pain group) vs. M = 2.0 (no-pain group)]. CONCLUSION: Our study shows that with comparable implementation of CT-guided periradicular therapy, the outcome of the patient with specific back pain can be significantly improved by certain behavioral patterns of the performing physician and this without side effects and without significant additional time expenditure. Our findings indicate that there is a non-negligible psychological factor linking confidence in therapy to actual therapy success. TRIAL REGISTRATION: The study was designed as an observational study, therefore a trial registration was not necessary.
Authors: Joseph L Dieleman; Ranju Baral; Maxwell Birger; Anthony L Bui; Anne Bulchis; Abigail Chapin; Hannah Hamavid; Cody Horst; Elizabeth K Johnson; Jonathan Joseph; Rouselle Lavado; Liya Lomsadze; Alex Reynolds; Ellen Squires; Madeline Campbell; Brendan DeCenso; Daniel Dicker; Abraham D Flaxman; Rose Gabert; Tina Highfill; Mohsen Naghavi; Noelle Nightingale; Tara Templin; Martin I Tobias; Theo Vos; Christopher J L Murray Journal: JAMA Date: 2016-12-27 Impact factor: 56.272
Authors: Zachary L McCormick; Daniel Cushman; Benjamin Marshall; Mary Caldwell; Jaymin Patel; Leda Ghannad; Christine Eng; Steven Makovitch; Ashwin Babu; Samuel K Chu; Christina Marciniak; David R Walega; Joel Press; Christopher Plastaras; David J Kennedy Journal: PM R Date: 2016-04-06 Impact factor: 2.298
Authors: Louise J Geneen; R Andrew Moore; Clare Clarke; Denis Martin; Lesley A Colvin; Blair H Smith Journal: Cochrane Database Syst Rev Date: 2017-01-14