University of Oulu

Simula, A., Jenkins, H.J., Holopainen, R. et al. Transcultural adaption and preliminary evaluation of “understanding low back pain” patient education booklet. BMC Health Serv Res 19, 1010 (2019).

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

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Author: Simula, Anna Sofia1,2,3; Jenkins, Hazel J.4,5; Holopainen, Riikka6;
Organizations: 1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Faculty of Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
3Department of General Medicine Mikkeli Central Hospital (Essote), Mikkeli, Finland
4Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Balaclava Road, North Ryde, NSW, 2109, Australia
5Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
6Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, FI-40014, Jyväskylä, Finland
7School of Health and Social Studies, JAMK University of Applied Sciences, PO BOX 207, FI-40101, Jyväskylä, Finland
8Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland
9Finnish Institute of Occupational Health, P.O. Box 40, FI-00032, Helsinki and Oulu, Työterveyslaitos, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.5 MB)
Persistent link:
Language: English
Published: Springer Nature, 2019
Publish Date: 2020-02-11


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 (n = 136) and practitioners (n = 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.

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Series: BMC health services research
ISSN: 1472-6963
ISSN-E: 1472-6963
ISSN-L: 1472-6963
Volume: 19
Issue: 1
Article number: 1010
DOI: 10.1186/s12913-019-4854-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Funding for research nurse (sampling the web-based questionnaire data) in Mikkeli awarded from The South Savo Social and Health Care Authority (ESSOTE). The research nurse will work separately from everyday clinical work in ESSOTE, she will not undertake any clinical work in ESSOTE and she will not be able to affect any decisions related to patient care. ESSOTE did not influence the study design; data collection; data analysis, decision to publish, or preparation of the manuscript.
Copyright information: © The Author(s). 2019 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver( applies to the data made available in this article, unless otherwise stated.