Background: Cross-sectoral care comprises interdisciplinary and coordinated efforts for patients with complex care needs involving various competencies and professions across the primary health care sector, hospital sector, and municipal services. Cross-sectoral care can increase the effectiveness of rehabilitation programmes, but the treatment courses often lack coherence. Establishing successful treatment pathways requires a better understanding of the health care challenges faced by patients with low back pain. The aim of this study was to explore how patients with low back pain experience cross-sectoral care. Method: A qualitative interview study including 25 patients with low back pain. Patients were recruited in connection with their appointment at the Spine Centre of Southern Denmark. Recruitment stopped when the interviews no longer added new knowledge to the subject. The data were analysed using a systematic text condensation approach. Results: Patients with low back pain experienced cross-sectoral care to be fragmented, with episodes lacking collaboration, information, and acknowledgement of their problem. They desired recognition of having a serious back problem and of being more than the diagnosis itself. Patients found it hard to keep track of their course of treatment due to a perceived lack of organisational support and collaboration between professionals. The patients called for more information about the treatment plan and the reasons for further referral in order to better understand and manage their treatment. Conclusion: Patients' experiences indicate a need for a stronger person-centred approach in cross-sectoral care, in which the individual's experiences of living with low back pain are taken into account.

Background: Patients with back pain increasingly demand MRIs to be part of their assessment. However, in most back pain patients, MRI does not appear to have diagnostic value. Nevertheless, it has been shown that patients who receive an MRI are more satisfied with their treatment even though the imaging may not facilitate their return to well-being.  Aim: To explore back pain patients’ expectations of and attitudes towards the value of MRI and to understand the relationship between their expectations and patient satisfaction.Methods: A qualitative study using observations and informal interviews with 62 back pain patients was conducted. Data were analysed according to Malterud’s systematic text condensation method.Results: Patients perceived MRIs to be an objective visual image of the body that could show them where their back pain was originating. Patients expected MRIs to provide them with a biomedical diagnosis; they considered MRIs to be the ‘true objective’ diagnosis, which would allow them to access various services and support and would lead to legitimization of their pain. The patients’ perceived value of MRI was very high; MRIs gave patients a feeling of being understood and taken seriously. Patients and clinicians had different ideas about the diagnosis of back pain, which could challenge how patients experience the benefits of treatment.Conclusion: For patients with back pain, the MRI is a valuable tool that leads to their 'real' diagnosis and enables recognition and legitimisation of their experienced pain. To meet patients' expectations, a better understanding of how MRIs are used in diagnosis and treatment must be achieved. Based on our study, we suggest that information about symptoms and the additional information an MRI can provide be clarified to the patient before assessment of back pain.

Background: While interdisciplinary, cross-sectoral collaboration promotes the effectiveness of rehabilitation programmes for persons with low back pain, challenges remain for this process. Few studies have explored challenges to cross-sectoral care as experienced by all the involved professionals across sectors during a course of treatment. The aim of this study was to explore challenges to cross-sectoral care as experienced by professionals involved in the course of treatment for patients with low back pain. Method: This semi-structured, qualitative interview study included 28 health care professionals and 8 social workers who interacted with patients with low back pain. A systematic text condensation method was used to analyse data. Nvivo was used to structure and thematise the interview data. Results: Professionals expressed challenges in relation to a lack of collaboration, knowledge sharing and acknowledgement of one other and they appeared to differ in their approach to patients with pain or patients with limited function. Additional challenges included time constraints, availability and subjective approaches to managing guidelines for low back pain. A lack of a common information technology (IT) registration system and limited knowledge of the work of other professions disrupted knowledge sharing among sectors. Discussion: The different approach to patients with pain or patients with limited function challenged mutual understanding and collaboration among professionals. The lack of mutual understanding and knowledge of each other's work appeared to create an environment of disrespect and distrust among professionals that generated feelings of a lack of acknowledgement from other health care professionals. Conclusion: To provide cross-sectoral care, we must ensure that professionals work together towards transparent and informed transitions from one sector to the next. This study contributes to the existing literature by presenting challenges to cross-sectoral care that are experienced by the diverse groups of professionals involved in a course of treatment for patients with low back pain.