Libby,
I would hope no-one on the list would shoot you down for question-asking. We
all have our preferred areas that we may know a little more about, and
should be happy to exchange that with others.
So what are yellow flags? I'm sure others may wish to contribute their
perceptions, but it appears they are an extension to the concept of red
flags (signs of serious pathology) to the easily understood idea of yellow
flags that indicate psychosocial barriers to recovery.
I have a green flag in my department that I wave when I discharge clients!
There is a little further on this in the reference below.
Regards,
Michael
Kendall NA.
Psychosocial approaches to the prevention of chronic pain: the low back
paradigm.
Baillieres Best Pract Res Clin Rheumatol. 1999 Sep;13(3):545-54. Review.
. ---- Original Message -----
From: "Libby MacGregor" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, March 25, 2000 6:10 PM
Subject: Re: Yellow flags what are they?
> Dear List
> At risk of being shot down or atleast regarded as stupid, could someone
> please explain where the term Yellow Flags came from and exactly what they
> are?
> Many thanks
> Libby
> ----- Original Message -----
> From: crm3a <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Saturday, March 25, 2000 7:59 AM
> Subject: Re: Yellow flags - how to use them
>
>
> > Just to muddy the waters abit....
> >
> > The idea of yellow flags is all very well and another nice theory that
we
> > have become fond of in the last few years. Interestingly enough the
kappa
> > value for Waddells signs of nonorganic back pain have been listed as low
> as
> > .3 . This is about the same as having little or no agreement between
> > examiners. If the test is unreliable what action should you be taking
> with
> > respect to your patients?. Perhaps we are playing "pop psychologist"
and
> we
> > should think twice about the validity of using these guidelines to
> influence
> > patient care.
> >
> > Cheers, Ross.
> >
> >
> > ----- Original Message -----
> > From: Paul Sumner <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Friday, March 24, 2000 7:15 AM
> > Subject: Re: Yellow flags - how to use them
> >
> >
> > > Carol,
> > > Have you directed your colleagues to the excellant articles, that
cover
> > some of these fears/questions that you described, in Physiotherapy vol
85,
> > No 10.October 1999 "Psychosocial assessment.& ""Back pain"- assessment
of
> > psychological distress in patients with LBP.
> > >
> > > >>> Carol David <[log in to unmask]> 03/10/00 06:08PM >>>
> > > Along the lines of spinal psychology - my acute OPD colleagues are
> > > starting to get very interested in yellow flags here and aim to
prevent
> > > their patients ending up on my chronic pain management books.
> > > They seem to assume I know all about it as I work with a psychologist,
> > > but I haven't a clue when it comes to acute stuff.
> > >
> > > So a few questions from them -
> > >
> > > 1. If you have an acute patient, and you're identifying yellow flags,
> > > what do you do about it - apart from realising that your patient is
not
> > > going to be "cured" in a hurry?
> > >
> > > 2. Also, does anyone have any ideas about how to screen for patients
who
> > > need more than the usual acute OPD treatment without subjecting them
to
> > > a battery of psychological tests? We're looking into a flow chart
which
> > > involves various questionnaires at various stages of a patient's
> > > progress, but so far it looks like they're going to spend more time
> > > analysing the paperwork than treating the patient (who is going to
spend
> > > more time filling in questionnaires than they spend with the physio.)
> > >
> > > 3. The other issue is that staff are a bit concerned about becoming
> > > "amateur psychologists" and feel that standard physio training doesn't
> > > adequately equip them to deal with some of the issues. Should we be
> > > saying that junior physios shouldn't treat backs because of the
complex
> > > psychology of back pain, and they could be doing more harm than good
by
> > > perpetuating fear of movement etc? or is there a quick way to get the
> > > important information over to them so they treat their patients more
> > > effectively earlier in their career?
> > >
> > > Sorry if this sounds a bit woffly but acute practice isn't my forte,
and
> > > I know that some of you out there are experts in this sort of thing.
> > >
> > > Regards,
> > >
> > > Carol David
> > >
> > >
> >
> >
>
>
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