How Are Different Back Interventions Chosen?
There is a lot of research being done in the area of lower back pain, including searching for key factors in back disability prevention. Participants in this Delphi panel comprising 14 researchers, eight occupational health managers or consultants, seven clinical practitioners, two insurance organization employees and two worker advocates, undertook to find what influenced the choices for back disability prevention interventions.
The panel members were given summaries of 32 modifiable factors that were associated with pain-related disability. Increased fitness, expectation of recovery, access to alternative care, decreased physical workload and lifting devices were some of the 32 that were listed. The panel chose the factors that they each felt were most important and they were asked to rank them in order of their relative impact on the patients, in their opinion. The impacts were, for example, quality-of-life and ability to work. After ranking the factors, the panel was asked to explain what influenced their choices.
The researchers found that the panel members made their choices based largely on their own personal experiences and their views on the nature of back disability, expectations of how interventions would be implemented, as well as they typical patients or workers and their own values. Another factor was whether the injury was work-related.
Other findings indicated that educational background and current affiliation did not play a large role in choosing priorities.
The researchers concluded that there were two main clusters in choice of priorities for interventions to prevent back injuries: personal experience and issues that separated the impact from modifiable behaviors.
Jaime Guzman, PhD, et al. Key Factors in Back Disability Prevention. What Influences the Choice of Priorities. In Spine.April 2007. Vol. 32. No. 9. Pp. E281-E289.