The experience of patients admitted to hospital with acute low back pain: a qualitative study

El-Haddad, Carlos; Damodaran, Arvin; McNeil, H. Patrick; Hu, Wendy

doi:10.1111/1756-185x.12870

Cited by 12 publications

(6 citation statements)

References 24 publications

(27 reference statements)

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“…Semi-structured interview prompts (Table 1) focused on the patient's current presentation and experience of health care in relation to their medical condition(s). These were developed based on the literature on patient expectations as well as a previous qualitative study we conducted exploring the patient experience in hospital (7,8,12,15,24). Interview topics explored the illness experience, interactions with health-care clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations.…”

Section: Sampling Strategy and Data Collectionmentioning

confidence: 99%

“…In 2017, the authors conducted several studies investigating the experience and expectations of patients admitted to hospital with acute low back pain (LBP) (12,13). We found patients had distinct expectations of health care regarding the need for investigations such as imaging studies, treatment modalities, and the provision of follow-up appointments.…”

Section: Introductionmentioning

confidence: 99%

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Understanding Patient Expectations of Health Care: A Qualitative Study

El-Haddad

Hegazi

2020

Journal of Patient Experience

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Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.

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Section: Sampling Strategy and Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding Patient Expectations of Health Care: A Qualitative Study

El-Haddad

Hegazi

2020

Journal of Patient Experience

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“…Negative beliefs about pain were associated with hospitalisations within the context of emergency departments [ 44 ], particularly around illness perception and patients’ urgency for investigation and hospital-based care. Helplessness and expectations of medical interventions to allow return to premorbid function were common themes from a qualitative study of patients hospitalised for LBP [ 19 ]. Escalating pain levels, distress and disability attributed to personal and contextual factors influenced patients’ decisions to attend an emergency department for non-specific pain conditions [ 65 – 67 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic review of predictors of hospitalisation for non-specific low back pain with or without referred leg pain

Orlando,

Beard,

Guerin

et al. 2023

PLoS ONE

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Significant costs and utilisation of healthcare resources are associated with hospitalisations for non-specific low back pain despite clinical guidelines recommending community-based care. The aim of this systematic review was to investigate the predictors of hospitalisation for low back pain. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42021281827) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Database search of Ovid Medline, Emcare, Embase, PsycINFO, Cochrane Library, PEDro and OTSeeker was conducted. Studies were included if they examined a predictor of hospitalisation for non-specific low back pain with or without referred leg pain. Data was extracted and descriptively synthesised. Risk of bias of included studies was assessed using the Critical Appraisal Skills Programme Checklists. There were 23 studies published over 29 articles which identified 52 predictor variables of hospitalisation for low back pain. The risk of hospitalisation was grouped into themes: personal, health and lifestyle, psychology, socioeconomic, occupational, clinical, and health systems and processes. There was moderate level evidence that arrival to an emergency department via ambulance with low back pain, and older age increase the risk of hospitalisations for low back pain. There was low level evidence that high pain intensity, past history of low back pain, opioid use, and occupation type increase the risk of hospitalisation for low back pain. Further research into psychological and social factors is warranted given the paucity of available studies. Hospital avoidance strategies, improved patient screening and resource utilisation in emergency departments are considerations for practice.

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“…50 The experiences of the few of our participants who had problematic interactions with staff related to pain management were echoed in several other studies of hospitalized patients who experienced pain. For example, a study by El-Haddad et al 51 revealed that patients hospitalized with acute low back pain were unable to communicate the severity of their pain to staff and felt the staff minimized their pain; a study Bernhofer et al 52 revealed that patients hospitalized with irritable bowel disease reported that they were judged or discredited by staff for experiencing pain, and a study by Coleman et al 53 revealed that patients with sickle cell anemia reported they felt misunderstood or not believed when reporting their pain levels. While problematic interactions with staff were reported in our sample, none of our participants discussed feeling stigmatized or doubted about their level of pain.…”

Section: Discussionmentioning

confidence: 99%

Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients

Winton

Draucker

2020

Cancer Nurs

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Background Brain tumors account for the majority of central nervous system tumors, and most are removed by craniotomies. Many postcraniotomy patients experience moderate or severe pain after surgery, but patient perspectives on their experiences with pain management in the hospital have not been well described. Objective The aim of this study was to describe how patients who have undergone a craniotomy for brain tumor removal experience pain management while hospitalized. Methods Qualitative descriptive methods using semistructured interviews were conducted with patients on a neurological step-down unit in an urban teaching hospital in the Midwest United States. Interviews focused on how patients experienced postcraniotomy pain and how it was managed. Narratives were analyzed with standard content analytic procedures. Results Twenty-seven participants (median age, 58.5 years; interquartile range, 26–41 years; range, 21–83 years) were interviewed. The majority were white (n = 25) and female (n = 15) and had an anterior craniotomy (n = 25) with sedation (n = 17). Their pain experiences varied on 2 dimensions: salience of pain during recovery and complexity of pain management. Based on these dimensions, 3 distinct types of pain management experiences were identified: (1) pain-as-nonsalient, routine pain management experience; (2) pain-as-salient, routine pain management experience; and (3) pain-as-salient, complex pain management experience. Conclusions Many postcraniotomy patients experience their pain as tolerable and/or pain management as satisfying and effective; others experience pain and pain management as challenging. Implications for Practice Clinicians should be attuned to needs of patients with complex pain management experiences and should incorporate good patient/clinician communication.

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The experience of patients admitted to hospital with acute low back pain: a qualitative study

Cited by 12 publications

References 24 publications

Understanding Patient Expectations of Health Care: A Qualitative Study

Understanding Patient Expectations of Health Care: A Qualitative Study

Systematic review of predictors of hospitalisation for non-specific low back pain with or without referred leg pain

Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients

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