RESEARCH ARTICLE


What is the Experience of Receiving Health Care for Neck Pain?



Joy C MacDermid*, 1, David M Walton2, Jordan Miller3, ICON
1 School of Rehabilitation Science, McMaster University, Hamilton, Ontario and Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario, Canada
2 School of Physical Therapy, Western University, London, Ontario, Canada
3 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada


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© MacDermid et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the School of Rehabilitation Science, IAHS, 1400 Main Street West, 4th Floor, Hamilton, ON, L8S 1C7, Canada; Tel: 905-525-9140, Ext. 22524; Fax: 905-524-0069; E-mail: macderj@mcmaster.ca
§ International Collaboration on Neck (ICON).


Abstract

This study used a descriptive phenomenological approach to describe the experience of finding and receiving health services for neck pain. Nineteen participants (18 females, 1 male) with neck pain (>3 months) were interviewed using a semi-structured questionnaire guide. Interviews were recorded, transcribed and coded. Two overarching themes described the experience: complexity in finding effective health care; and the need for informative, personalized, respectful communication. Complexity in finding effective health care was attributed to the variable approach and effectiveness of different health professionals, the need to experiment with care to find what works, the need to differentiate temporary versus permanent treatment effects, concerns about treatment side effects and the sense that financial factors influence personal treatment choices and provider behaviours. The need for informative, personalized, respectful communications was broken down into the following subthemes: the importance of being listened to, seen and believed; the need for useful information; and a desire to have outcomes formally tracked as a means of individualizing treatment. Overall, patients struggled to navigate the variable health services and providers that were available and that provided variable outcomes. They often did so through a trial and error approach. As such, patients remain open to unproven, even controversial treatment options. Research evidence was not a key ingredient in patient decision-making about accessing health services. The environmental, personal, health behavior factors interacted to contribute to health service utilization and would increase the burden of these for both the individual and society at large. The effectiveness of neck pain interventions is dependent on complex interactions between the context, individual, and health care provider, therefore, physiological responses cannot be considered as being distinct from these determinants.

Keywords: Neck pain, health service, effectiveness, utilization, qualitative, communication, access.