|
|
Guide
to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk
Factors for Long-Term Disability and Work Loss
Appendix
3: What methods can be used to identify Psychosocial Yellow Flags?
There are two major methods that can
be used:
- structured questionnaire
- clinical assessment
A combination of both can also be
used. The method chosen will depend on the clinical setting, and the
treatment provider’s personal confidence at assessing these issues.
The advantages and disadvantages of
the various methods are listed in Table 2. Become familiar with these
in order to be able to counteract any disadvantages for the method
chosen. Table 2:
Advantages and disadvantages of questionnaires and clinical assessments
| Advantages of
questionnaires |
- Quick to administer
- Useful for screening large
numbers
- Little skill needed
- Interpretation is usually
unequivocal
- Can be statistically based on
evidence
|
| Disadvantages of
questionnaires |
- Require time to score, need to
check for missing information
- Unsuitable for those with
reading problems
- May not be applicable to all
members of a community, eg, new immigrants
- May only predict one goal, eg,
work loss but not pain
- May be too sensitive to time
of measurement
- Susceptible to confounding
factors, such as social desirability, or ‘impression
management’ such as the person telling you what they think
you want to hear
|
| Advantages of clinical
assessments |
- Clinician can adapt readily to
characteristics of the individual
- Incorporates clinical
experience
- Facilitates establishing
potential goals for intervention
- Less susceptible to
confounding factors, such as social desirability or ‘impression
management’
- Judgements about severity can
be made
|
| Disadvantages of clinical
assessments |
- Potentially time consuming
- May result in confused picture
unless clinical skill level is adequate
- Possibility of observer bias
or prejudice Advantages of combinations of questionnaires with
clinical assessments
- Improved accuracy
- Clinician can integrate
quantitative information with clinical data
- Can use two stage process with
questionnaire as first stage filter to target clinical
assessments Disadvantages of combinations of questionnaires with
clinical assessments
- Require more resources,
including the need for adequate organisation and training
- More time needed, potential
for delays
|
|