217 | P a g e 13. SLADE 2015 [193]: Barriers to Guideline Implementation- Beliefs That Imaging Will Lead to a Definitive Diagnosis There is a risk that I might miss underlying spinal pathology if I don’t refer for imaging. There is also the worry about litigation. It can also facilitate patient engagement in treatment. I am a bit uncomfortable with the term “nonspecific” LBP you can always identify a definitive, patho-anatomic cause and diagnosis. I always want to give a diagnosis. I don’t need to utilise psychosocial assessment and treatment approaches and it is not my place to use these approaches. HEALTHCARE PROFESSIONALS 14. SLADE 2015[193]: Barriers to Guideline Implementation- Beliefs About Knowledge Limitations and Professional Role and Identity I am not confident about assessing and treating LBP. Some HCPs are more confident. I think that there is a biomedical diagnosis/cause for pain but the “art of caregiving” is also important. This is underpinned by intuition and creativity. HEALTHCARE PROFESSIONALS 15. SLADE 2015 [193]: Maintaining the Patient-Clinician Relationship With Imaging Referrals I use imaging results to explain the problem, to relieve anxiety and to encourage optimism. An “unambiguous explanation” can increase trust and help my patient to engage in treatment. At times I order a test if I don’t have time to discuss the options fully. HEALTHCARE PROFESSIONALS 16. SLADE 2015 [193]: Maintaining the Patient-Clinician Relationship With Imaging Referrals - Imaging Referrals are Used to Manage Patient Beliefs and Expectations I tailor my treatment to my patients expectations and experiences, ways of coping, fears and anxieties, and cultural influences, despite the guidelines. I am more likely to refer a more demanding patient. HEALTHCARE PROFESSIONALS
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