Abstract
Introduction
Despite its clinical utility, progressive reliance on imaging technology can lead to devaluing the physical examination in patients with chronic pain. The primary objective of this study was to determine whether chronic pain patients have a positive or negative perception of the physical examination.
Methods
After institutional ethics committee approval, 120 adult patients as a convenience sample who attended a chronic pain clinic were included. Participants completed a 10-item survey regarding their overall perception of the physical examination. Kruskal-Wallis and Mann-Whitney U test analyses were conducted to explore associations between test items and patient ages, gender, employment, pain diagnosis, and duration of pain. All cross-tabulations of categorical variables were analyzed using Fisher’s exact test for associations.
Results
The majority of participants were male (51%), aged 50–70 (44%). The most common pain diagnosis was back pain (62%). Most patients (77%) indicated that the overall experience of being examined was highly positive. Patients believe in the value of the physical examination as a diagnostic tool (97%). Patients believe in the relational value of the physical examination (92%). Age, gender, employment, pain diagnosis, and duration of pain were not associated with a more positive perception of the physical examination.
Conclusion
Patients with chronic pain indicate that the physical examination is a highly positive aspect of their care. There are some negative aspects of been examined which physicians should be aware of. This study adds to our knowledge regarding the physical exam in chronic pain patients. It will inform practice and training.
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References
- 1.
Fitzgerald FT (1990) Physical diagnosis versus modern technology. A review. West J Med 152:377–382
- 2.
Verghese A, Horwitz RI (2009) In praise of the physical examination [serial online]. BMJ 339:b5448
- 3.
Oboler SK, Prochazka AV, Gonzales R et al (2002) Public expectations and attitudes for annual physical examinations and testing. Ann Intern Med 136:652–659
- 4.
Kravitz RL, Cope DW, Bhrany V, Leake B (1994) Internal medicine patients’ expectations for care during office visits. J Gen Intern Med 9:75–81
- 5.
Brody DS, Miller SM, Lerman CE et al (1989) The relationship between patients’ satisfaction with their physicians and perceptions about interventions they desired and received. Med Care 27:1027–1035
- 6.
Kravitz RL, Bell RA, Azari R et al (2002) Request fulfillment in office practice: antecedents and relationship to outcomes. Med Care 40:38–51
- 7.
Kravitz RL, Callahan EJ (2000) Patients’ perceptions of omitted examinations and tests: a qualitative analysis. J Gen Intern Med 15:38–45
- 8.
Lillrank A (2003) Back pain and the resolution of diagnostic uncertainty in illness narratives. Soc Sci Med 57(6):1045–1054
- 9.
Kenny DT (2004) Constructions of chronic pain in doctor-patient relationships: bridging the communication chasm. Patient Educ Couns 52(3):297–305
- 10.
Crofford LJ (2015) Psychological aspects of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 29(1):147–155
- 11.
Atkinson S, Macnaughton J, Saunders C, Evans M (2010) Cool intimacies of care for contemporary clinical practice. Lancet 376:1732–1733
- 12.
Pohl G, Seemann H, Zojer N et al (2007) “Laying on of hands” improves well-being in patients with advanced cancer. Support Care Cancer 15:143–151
- 13.
Kadakia KC, Hui D, Chisholm GB et al (2014) Cancer patients' perceptions regarding the value of the physical examination: a survey study. Cancer 120(14):2215–2221
- 14.
McNaughton DT, Hush JM, Beath AP et al (2018) No moderating impact of a medically unexplained etiology on the relationship between psychological profile and chronic pain. J Psychosom Res 115:87–93
- 15.
Battalio SL, Glette M, Alschuler KN, Jensen MP (2018) Anxiety, depression, and function in individuals with chronic physical conditions: a longitudinal analysis. Rehabil Psychol 63(4):532–541
- 16.
Elkiss ML, Jerome JA (2012) Touch—more than a basic science. J Am Osteopath Assoc 112:514–517
- 17.
Howe CQ, Robinson JP, Sullivan MD (2015) Psychiatric and psychological perspectives on chronic pain. Phys Med Rehabil Clin N Am 26(2):283–300
- 18.
Phillips LA, Carroll LJ, Voaklander DC et al (2012) Pain coping in injured workers with chronic pain: what’s unique about workers? Disabil Rehabil 34(21):1774–1782
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The Institutional Research and Ethics Committee of the University Hospitals Limerick, Ireland, approved all study procedures.
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Hashim, M.M., Edgeworth, D.M., Saunders, J.A. et al. Patient’s perceptions of physical examination in the setting of chronic pain. Ir J Med Sci 190, 313–316 (2021). https://doi.org/10.1007/s11845-020-02250-2
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Keywords
- Chronic pain
- Patient satisfaction
- Physical examination