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Factors influencing physician manage...

New York University., Program in Environmental Health Sciences.

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Factors influencing physician management of nonspecific low back pain.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Factors influencing physician management of nonspecific low back pain./
Author:	Weiner, Shira Schecter.
Description:	186 p.
Notes:	Adviser: Sherri Weiser.
Contained By:	Dissertation Abstracts International69-09B.
Subject:	Health Sciences, Health Care Management. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3330183
ISBN:	9780549823216

Factors influencing physician management of nonspecific low back pain.
Weiner, Shira Schecter.

Factors influencing physician management of nonspecific low back pain. - 186 p.

Adviser: Sherri Weiser.

Thesis (Ph.D.)--New York University, 2008.

Conclusion. Nonclinical factors, including gender, SES, PP are associated with primary care physician treatment for ANSLBP. Patient gender did not influence adherence to the EBG.

ISBN: 9780549823216Subjects--Topical Terms:

1017922
Health Sciences, Health Care Management.

Factors influencing physician management of nonspecific low back pain.
LDR:03549nmm 2200385 a 45 001 890541
005 20101103
008 101103s2008 eng d
020 $a 9780549823216
035 $a (UMI)AAI3330183
035 $a AAI3330183
040 $a UMI $c UMI
100 1 $a Weiner, Shira Schecter. $3 1064489
245 1 0 $a Factors influencing physician management of nonspecific low back pain.
300 $a 186 p.
500 $a Adviser: Sherri Weiser.
500 $a Source: Dissertation Abstracts International, Volume: 69-09, Section: B, page: 5312.
502 $a Thesis (Ph.D.)--New York University, 2008.
520 $a Conclusion. Nonclinical factors, including gender, SES, PP are associated with primary care physician treatment for ANSLBP. Patient gender did not influence adherence to the EBG.
520 $a Objective. To identify factors associated with physician TR for ANSLBP.
520 $a Study design. A fully blocked experiment using vignettes to query primary care physicians about treatment recommendations (TR) for acute nonspecific low back pain (ANSLBP).
520 $a Summary of background data. There is evidence of gender bias in health care. Little has been written about gender bias and ANSLBP. In assessing ANSLBP, physicians rely on patients' subjective reports when choosing treatment. Evidence based guidelines (EBG) may be useful, but adherence has been questioned. Socioeconomic status (SES) and case presentation (PP) are subsets of gender, as specific attributes of each are gender-specific. This is an exploratory study to identify if gender, SES and PP are associated with physician TR for ANSLBP and to determine the level of EBG adherence based on patient gender.
520 $a Methods. Primary care physicians at five urban teaching hospitals (n=284) read a vignette describing a case of ANSLBP and answered questions covering six domains of treatment (diagnostics, medication, therapeutic procedures, activity recommendations, referral to other services). The exposure variables, gender (male, female), SES (high, medium and low) and PP (somatic, affective) were tested at all levels. Recommended treatment was the outcome. All treatments were categorized as those supported or unsupported by the EBG. Bivariate analysis and logistic regression were used to identify independent and interactive associations for the exposure and outcome variables. Adherence to EBG was assessed by percentage of treatment in each EBG category for male and female cases.
520 $a Result. The findings suggest an independent association of gender, SES and PP with 9 of 63 TR (p=<0.05), with PP being most influential. Pain management (OR 3.95 (CI 0.91-13.24) was associated with female cases. High SES patients were more likely to receive TR that promoted return to activity (OR range=0.35-0.72) and low SES received TR that restricted activity OR 2.33 (CI 1.10-4.92). Affective cases received more recommendations for all treatments associated with PP (OR range=0.33-0.60). The rate of adherence to EBG was approximately 58%-73% and was independent of patient gender.
590 $a School code: 0146.
650 4 $a Health Sciences, Health Care Management. $3 1017922
650 4 $a Health Sciences, Medicine and Surgery. $3 1017756
690 $a 0564
690 $a 0769
710 2 0 $a New York University. $b Program in Environmental Health Sciences. $3 1025247
773 0 $t Dissertation Abstracts International $g 69-09B.
790 $a 0146
790 1 0 $a Campello, Marco $e committee member
790 1 0 $a Carragee, Eugene $e committee member
790 1 0 $a Nordin, Margareta $e committee member
790 1 0 $a Rapp, Rayna $e committee member
790 1 0 $a Weiser, Sherri, $e advisor
791 $a Ph.D.
792 $a 2008
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3330183