What’d Ya Say? Divided By a Common Language.

applesoranges

The importance of using common language when communicating about back pain has been well documented in the medical literature. There are three main areas that lead to difficulties in communication about back pain:

  • patients seeking information from health care professionals can experience difficulties understanding them and the medical literature
  • misunderstandings among health professionals concerning terminology can arise
  • lack of standardized definitions for back pain terms can make comparison of research studies problematic

A study just published in the BMC Musculoskeletal Disorders aimed to explore the meanings and issues surrounding the use of existing medical terms for back pain from the perspective of health care professionals and lay people. Focus groups were used to explore participants’ understanding and samples included general practitioners, chiropractors, osteopaths, physiotherapists, and lay people.

Lay participants understood the majority of the terms explored in the group differently than the health professionals. Some terms were not understood, some misconstrued and some had inadvertent negative connotations or implications. (For example “wear and tear” instead of the harsher term “degeneration” gave implications of wearing away or rotting).   The commonness of misunderstandings, unintended meanings and negative emotional responses to terms used in this study have a number of implications.

Firstly, it must encourage providers to ensure their patients understand what has been explained to them including the contextual and emotional implications. Secondly, patients and providers should have an ongoing dialogue to promote understanding of terms and comminality of language.  Third, this study should be used as a lesson to chiropractors who cling to old, antiquated terminology that we know has differing meanings both intra- and interprofessionally. If other chiropractors cannot agree on a term’s meaning, and other professions cannot agree on that term’s meaning, you can sure as heck bet that your patients have no idea what you are taking about either.

I was recently told that we should take antiquated terms and reframe them so we can continue using them in a different context. To me, this study implies that is not a wise course of action.

 

Brett L. Kinsler, DC is a chiropractor in Rochester, NY who avoids using antiquated terms when he blogs at www.RochesterChiro.wordpress.com

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3 Comments

  1. October 28, 2009 at 9:28 am

    Excellent commentary regarding communication, and the lack thereof. Perhaps a key issue may be that no matter the language chosen to inform the patient, having the provider ask the patient to please explain back to the provider what they heard the provider say, would prove most beneficial.

  2. October 30, 2009 at 7:58 pm

    I was suprised you didn’t mention subluxation. Interesting read. Thanks!

  3. October 30, 2009 at 8:40 pm

    @Dr. Ventura: That’s excellent advice. Thanks!

    @Dr. Woodward: LOL..of course subluxation is what I was alluding to. I was instructed that chiropractors should re-embrace the term, reframe it and reclaim it. I don’t agree.


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