Low back pain week: 2 cases

I am glad to report that this week I was presented with not one, but two cases, both having to do with low back pain.

Case #1

Scenario

A French-speaking middle-aged man has been referred to me by his physician at the clinic. He suffers from chronic low back pain and would like to know which exercises might help.

Resolution

First I go to Passeportsanté, hoping to find something in French similar to the MedlinePlus interactive tutorials, or at least with illustrated exercises.

Passportsanté > A-Z > D > Dos (mal de). This takes you to the same page as Douleurs lombaires.

Unfortunately there are no illustrations and certainly nothing interactive. I print it out anyway and then try CiSMeF (sites médicaux francophones à destination des patients et de leurs familles) to see what they have there.

CiSMeF > keywords: "exercises dos." I get two results, neither of which include illustrations, or even examples of exercises. Somewhat interesting though, so I print them out too.

Mal de dos: guide pratique
Mal de dos: pour faire le point

At this point I decide it's time to go to MedlinePlus. Since the information is illustrated, and the patient does speak some English, he will still be able to benefit from it.

MedlinePlus > keywords: "back exercises." I print out the list of results so he can access it again at home, and also print out the text summary of the interactive tutorial (which includes illustrations), and the second hit on the list which is a Low back pain exercise guide from the American Academy of Orthopaedic Surgeons.


Case #2

Scenario

One of the health professionals (HP) at the clinic comes into my room and asks if there is a pamphlet on back exercises. I know which one he is thinking of but we have run out.

Resolution

Since the patient speaks English and I have already fielded a similar question earlier in the week, I go directly to MyHq where I have bookmarked some useful links under the Pain management section.

I show the HP the aforementioned MedlinePlus interactive tutorial which he thinks is great (it really is), and Low back pain exercise guide from the American Academy of orthopaedic Surgeons, and this time I also include Low back pain: tips on pain relief and prevention from familydoctor.org.

I ask the HP to fill out an Rx so I can document the consultation and he is happy to do so even though it means returning to the exam room to get the patient's information (name, chart no.). I run into him later in the hall and he tells me he was impressed by how quickly I was able to find the information and that he is going to go back and explore MedlinePlus for himself.

Discussion

I often find that the French language information I am able to find is rich in theory and somewhat lacking in terms of image/illustration and maintaining an appropriate reading level. Fortunately most of the patients I see at the clinic are able to read enough English to still benefit from those resources. It is interesting to note that CiSMeF links directly from each topic to the corresponding section in MedlinePlus. All roads lead...

It is also interesting to note that this resource that we (librarians/information professionals) take for granted, is still not well known to all health professionals. I think this is true of many of the resources we use on a regular basis. I have noticed that health professionals at the clinic often request information in pamphlet form, even though they are all too aware that their patients are going online for information. The clinic used to have a "pamphlet room" and a pamphlet database, so I suspect that this is partly due to habit rather than ignorance.

Nutrition information in Cantonese: case

Scenario

A middle aged man is referred to me. He leaves a phone message telling me he is interested in information on Type II Diabetes and diet in Cantonese for his father who is a patient at the Herzl.

Resolution

I search the following resources*:

The 24 languages project
Health Information Translations
Healthy Roads Media
HICUP
NLM Consumer Health Information in Many Languages Resources
SPIRAL

I am able to find some good information in Chinese on the SPIRAL site:

SPIRAL > Patient information by language > Chinese > select "diabetes"

Unfortunately I am not able to determine whether this information is specifically in Cantonese (health information is generally available in either traditional or simplified Chinese). I call the man back and he asks me to email the links and says he will ask his father whether he is able to read the information. I tell him I will be happy to continue looking if necessary. He then asks if I can find something that might help his father understand the different food groups and portion sizes. I do a web search using Google: canadian food guide chinese. The first hit is a copy of the guide translated into Chinese (pdf).

I email these links to the man including some information about navigating the SPIRAL site.

I place a copy of the consultation form in the attending physician's mailbox.

*All of these resources have been bookmarked in the list of public MyHq bookmarks I have created for myself and the Herzl health staff.

Total time: 20 mins

Discussion

I consider every encounter an opportunity to teach people how to find information and not just hand it over. At the very least I show the path from the resource's home page to the desired information. This also minimizes dead links.