“We need to get you focused”: General practitioners’ representations of chronic low back pain patients.

Padraig MacNeela, Andrea Gibbons, Brian McGuire, Andrew Murphy

Research output: Contribution to journalArticlepeer-review


Although subject to considerable research from perspectives including general practitioners, patients, and perspective guidelines, chronic low back pain (CLBP) continues to be a common but contentious condition in primary care. We used medical consultation records, critical incident interviews, and a think-aloud problem-solving task to examine how general practitioners applied professional knowledge of the condition, especially in relation to psychosocial care. Using qualitative content analysis and thematic analysis, we identified a pragmatic, goal-focused approach to patients, a schema based on biomedical knowledge and tacit theories of motivation. The doctors’ expectations for CLBP included uncertainty over symptoms and doubts over patient credibility, which helped to explain an autonomous rather than collaborative approach to managing back pain patients. The findings are discussed in light of social representations theory, self-determination, and research on the therapeutic relationship.
Original languageEnglish
Pages (from-to)977-986
Number of pages10
JournalQualitative Health Research
Issue number7
Publication statusPublished - 2010


  • chronic illness
  • communication
  • doctor-patient
  • decision making
  • clinical
  • pain
  • chronic
  • relationships
  • Health care

Cite this