Back pain management in primary care: development and validity of the Patients' and Doctors' Expectations Questionnaire.

BACKGROUND Back pain is a common disorder, with the doctor being the first point of contact for help. Biopsychosocial management of back pain has been shown to be problematic. Meeting patients' expectations is alleged to play a vital role in concordance, adherence and satisfaction. A more potent aspect, however, could be a state of matched patient- doctor expectations with regard to the consultation process and outcome, but this aspect has not been fully investigated and there is currently no valid and specific measure of this dimension. AIM To report on the development of a newly designed patient and doctor expectations questionnaire that measures the matching of their expectations with regard to the back pain consultation in primary care, and to establish the validity and internal consistency of the new tool. METHODS A literature review was carried out and a draft 36-item questionnaire was developed. Thirty-eight subjects (7 researchers, 20 patients and 11 doctors) tested the questionnaire. Each subject gave feedback on the questionnaire design and was also asked to fill in a previously validated tool, the Patients' Intentions Questionnaire (PIQ), to establish the concurrent validity of the newly designed expectations questionnaire. Construct validity was established by calculating the Spearman correlation coefficient, and Cronbach's alpha was computed to reflect the internal consistency of the instrument. FINDINGS The results of the validity questionnaire showed that the questionnaire was perceived as simple, clear and easy to understand and appropriate to the intended aim. Spearman correlation coefficients between the Patients' Expectations Questionnaire and PIQ showed significant correlation ( r = 0.65), reflecting good concurrent validity, while Cronbach's alpha was 0.831, reflecting good internal consistency. CONCLUSION The newly designed questionnaire showed good face, content and construct validity as well as good internal consistency, and thus can be used as a valid and reliable measure for back pain-specific expectations of the process and outcome of the consultation in primary care settings.