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Family Practice Vol. 16, No. 4, 395-401
© Oxford University Press 1999

The early stages of low back pain: a pilot study of patient diaries as a source of data

Julia S Millera, Mark A Pinningtona,b and Ian M Stanleya,b

a Chester and Halton Community NHS Trust and
b Dept of Primary Care, University of Liverpool, Liverpool, UK.

Julia S Miller, Department of Physiotherapy, Chester and Halton Community Trust, Moston Lodge, Countess of Chester Health Park, Liverpool Rd, Chester CH2 1UL, UK.

Background. Low back pain accounts for a significant proportion of a GP's workload, but care of the condition is widely regarded as unsatisfactory. Recent recommendations to improve primary care management include more appropriate explanatory models and early access to physical therapy.

Objectives. This study explored the feasibility and utility of patient diaries as a source of qualitative data on patients' experience of low back pain presenting in primary care.

Method. Within a larger study of physiotherapist-led management of low back pain presenting in general practice, a random sample of patients was invited to keep a record of their illness experience over 7 days using a diary. Patients' written accounts were then subject to qualitative thematic analysis.

Results. Diary respondents did not differ from the wider group of patients presenting with back pain. Patients recounted diverse experience of disability, pain and emotional reactions. The specific themes which emerged from our analysis support the relevance to patients of a biopsychosocial paradigm in the management of low back pain.

Conclusions. Diaries are a feasible and valid source of qualitative data in patients with new episodes of low back pain. In addition, they may provide the clinician with useful information and their completion may offer direct benefits to patients.

Keywords. Health diary, illness experience, low back pain, new episode, primary care..


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M. A Pinnington, J. Miller, and I. Stanley
An evaluation of prompt access to physiotherapy in the management of low back pain in primary care
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