Recovery: What does this mean to patients with low back pain?

Hush, Julia M.; Refshauge, Kathryn M.; Sullivan, Gerard; Souza, Lorraine De; Maher, Christopher G.; McAuley, James H.

doi:10.1002/art.24162

Cited by 125 publications

(122 citation statements)

References 32 publications

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“…Both of these scenarios could result in different conclusions regarding GPE than what might be observed in other settings. The fact that our observations are similar to previous research in low back pain [8] diminishes this concern.…”

Section: Strengths and Limitationssupporting

confidence: 91%

“…This is supported by qualitative research demonstrating that low back pain patients cognitively appraise their symptoms, daily activities and quality of life when considering their recovery [8]. This is likely similar for those suffering from neck pain, where multiple factors have been shown to impact patients' experiences and behaviors [9].…”

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

“I know it’s changed”: a mixed-methods study of the meaning of Global Perceived Effect in chronic neck pain patients

et al. 2014

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Purpose Global Perceived Effect (GPE) is a commonly used outcome measure for musculoskeletal conditions like neck pain; however, little is known regarding the factors patients take into account when determining their GPE. The overall objective of this work was to describe the thematic variables, which comprise the GPE from the patient's perspective. Methods This was a mixed-methods study in which qualitative data were collected within a randomized clinical trial assessing exercise and manual therapy for chronic neck pain. A consecutive sample of 106 patients who completed the trial intervention took part in semi-structured interviews querying the meaning of GPE. Quantitative measures were collected through self-report questionnaires. Interview transcripts were analyzed using content analysis to identify themes, which were then quantified to assess potential relationships. Results A model of GPE for chronic neck pain emerged comprised of five main themes: neck symptoms (cited by 85 %), biomechanical performance (38 %), activities of daily living (31 %), self-efficacy (10 %), and need for other treatment (6 %). Influencing factors included those contributing to GPE: treatment process (64 %), biomechanical performance (51 %), self-efficacy (16 %), and the nature of the condition (8 %). Factors, which detracted from GPE or prevented recovery included perceived nature of condition (58 %), required daily activities (10 %), lack of diagnosis (5 %), and history of failed treatment (5 %). Conclusions GPE appears to capture chronic neck pain patient perceptions of change in different domains important to their individual pain experiences that may not be captured by other outcome instruments. Thus, GPE is a suitable patient-oriented outcome that can complement other measures in research and clinical practice. Importantly, many chronic neck pain patients believe it impossible to reach complete recovery because of a perceived intractable aspect of their neck condition; this has important implications regarding long-term disability and healthseeking behaviors.

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Section: Strengths and Limitationssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 95%

“I know it’s changed”: a mixed-methods study of the meaning of Global Perceived Effect in chronic neck pain patients

et al. 2014

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“…13 Schiller et al interviewed patients following hip fracture who described seeking support, moving more and preserving perspective as the fundamental factors in improving outcome, 26 whereas other studies reported that psychological health was considered by patients as an important marker of recovery. 27,28 Although we did not specifically target questions to determine quality of life factors or personality traits, interestingly, in this population, those discharged home commonly reported that family support and their own strength of mind and determination were the major factors in achieving their goals, whereas those discharged to in-patient rehabilitation seemed to focus on the importance of others in their recovery, often claiming that it was the rehabilitation staff who were the reason for their positive outcome. Locus of control appears to be an individual trait that does not change with different situations, especially with regard to health-related matters.…”

Section: Discussionmentioning

confidence: 99%

Discharge from the acute hospital: trauma patients’ perceptions of care

Kimmel

Holland

Hart

et al. 2016

Aust. Health Review

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Objective. The involvement of orthopaedic trauma patients in the decision-making regarding discharge destination from the acute hospital and their perceptions of the care following discharge are poorly understood. The aim of the present study was to investigate orthopaedic trauma patient experiences of discharge from the acute hospital and transition back into the community.Methods. The present qualitative study performed in-depth interviews, between October 2012 and November 2013, with patients aged 18-64 years with lower limb trauma. Thematic analysis was used to derive important themes.Results. Ninety-four patients were interviewed, including 35 discharged to in-patient rehabilitation. Key themes that emerged include variable involvement in decision-making regarding discharge, lack of information and follow-up care on discharge and varying opinions regarding in-patient rehabilitation. Readiness for discharge from in-patient rehabilitation also differed widely among patients, with patients often reporting being ready for discharge before the planned discharge date and feeling frustration at the need to stay in in-patient care. There was also a difference in patients' perception of the factors leading to recovery, with patients discharged to rehabilitation more commonly reporting external factors, such as rehabilitation providers and physiotherapy.Conclusion. The insights provided by the participants in the present study will help us improve our discharge practice, especially the need to address the concerns of inadequate information provision regarding discharge and the role of inpatient rehabilitation.What is known about the topic? There is no current literature describing trauma patient involvement in decision-making regarding discharge from the acute hospital and the perception of how this decision (and destination choice; e.g. home or in-patient rehabilitation) affects their outcome. HEALTH SERVICE RESEARCH What does this paper add?The present large qualitative study provides information on patients' opinion of discharge from the acute hospital following trauma and how this could be improved from their perception. Patients are especially concerned with the lack of information provided to them on discharge, their lack of involvement and understanding of the choices made with regard to their discharge and describe concerns regarding their follow-up care. There is also a feeling from the patients that they are ready to leave rehabilitation before their actual planned discharge date, a concept that needs further investigation. What are the implications for practitioners? The patient insights gained by the present study will lead to a change in discharge practice, including increased involvement of the patient in the decision-making in terms of discharge from both the acute and rehabilitation hospitals and a raised awareness of the need to provide written information and follow-up telephone calls to patients following discharge. Further research into many aspects of patient discharge from the acute hosp...

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“…While participants did not question the validity of the iBAQ questionnaire, there is increasing concern that the similar patient-reported outcome measures used in back pain trials may not measure aspects that are important to patients. [16][17][18] For clinical trial interpretation to be maximised, this needs to be a focus of future research.…”

Section: Strengths and Limitationsmentioning

confidence: 99%