A biopsychosocial content analysis of Dutch rehabilitation and anaesthesiology websites for patients with non-specific neck, back, and chronic pain

OBJECTIVES: Patients with non-specific neck, back, and/or chronic pain increasingly seek information about their condition on websites of healthcare practitioners. This information can influence their treatment expectation and should align with contemporary biopsychosocial (BPS) understanding of pain. It is unclear whether Dutch websites in the fields of rehabilitation and anaesthesiology align with the BPS model. The aim of this study is to assess the BPS content about non-specific neck, back, and chronic pain in Dutch rehabilitation and anaesthesiology websites.

METHODS: All Dutch rehabilitation and anaesthesiology webpages were potentially eligible for inclusion. All webpages focusing on the topics of neck, back, and chronic pain were included. BPS content analyses were performed according to a standardised rating method with criteria for biomedical, limited-, and reasonably BPS. Analyses were performed separately for specialisms, and for the three topics. Additionally, frequency of nocebo words usage on the websites is explored.

RESULTS: A total of 71 webpages were included, of which 42 (59.2%) were rehabilitation, 28 (39.4%) were anaesthesiology webpages, and 1 webpage described both. Across all webpages, 7 (9.7%) were rated as biomedical, 54 (75.0%) limited BPS, and 11 (15.3%) reasonably BPS. Differences between specialisms were not significantly different ( p = 0.055). Differences between BPS ratings and the topics were significant ( p = 0.005). Nocebos were present on 22.2% ( n = 16) of the webpages.

CONCLUSION: Majority of the anaesthesiology and rehabilitation webpages (84.7%) did not achieve a "reasonable biopsychosocial" rate. Improvements are particularly needed in describing pain as a universal and/or normal phenomenon experienced by most individuals, as well as in explaining how an individual's environment influences their thoughts, emotions, and behaviours regarding pain perception.