Transcultural adaption and preliminary evaluation of "understanding low back pain" patient education booklet

Anna Sofia Simula, Hazel J. Jenkins, Riikka Holopainen, Petteri Oura, Katariina Korniloff, Arja Häkkinen, Esa-Pekka Takala, Mark J. Hancock, Jaro Karppinen

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    BACKGROUND: Low back pain (LBP) is the number one cause of disability globally. LBP is a symptom associated with biological, psychological and social factors, and serious causes for pain are very rare. Unhelpful beliefs about LBP and inappropriate imaging are common. Practitioners report pressure from patients to provide inappropriate imaging. A recently developed patient education and management booklet, 'Understanding low back pain', was designed to target previously identified barriers for reducing inappropriate imaging. The booklet includes evidence-based information on LBP and supports communication between patients and practitioners. Our aim was to 1) describe the translation process into Finnish and 2) study patients' and practitioners' attitudes to the booklet and to evaluate if it improved patients' understanding of LBP and practitioners' ability to follow imaging guidelines. 

    METHODS: We translated the booklet from English to Finnish. Preliminary evaluation of the booklet was obtained from LBP patients (= 136) and practitioners (= 32) using web-based questionnaires. Open-ended questions were analysed using thematic analysis. 

    RESULTS: Approximately half of the patients reported that reading the booklet helped them to understand LBP, while a third thought it encouraged them to perform physical activity and decreased LBP-related fear. Eighty percent of practitioners reported that the booklet helped them to follow imaging guidelines. In addition, practitioners reported that they found the booklet helpful and that it decreased the need for imaging. 

    CONCLUSIONS: The booklet seemed to be helpful in LBP management and in decreasing the need for LBP imaging according to patients and practitioners. Further research on the clinical effectiveness of the booklet in controlled study settings is needed. 

    TRIAL REGISTRATION: ISRCTN, ISRCTN14389368, Registered 4 April 2019 - Retrospectively registered; ISRCTN11875357, Registered 22 April 2019 - Retrospectively registered.

    Original languageEnglish
    Article number1010
    Pages (from-to)1-11
    Number of pages11
    JournalBMC Health Services Research
    Publication statusPublished - 30 Dec 2019

    Bibliographical note

    Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


    • Back pain
    • Patient education
    • Back pain imaging
    • Implementation
    • Primary care


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