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Int J Rheum Dis ; 21(4): 796-803, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27125577

RESUMO

AIM: To understand the patient experience of being admitted to hospital with acute low back pain (LBP), with a view to developing suggestions for care and LBP management guidelines. METHOD: Interpretive phenomenological analysis (IPA) was adopted to examine semi-structured interviews from patients admitted to hospital with acute LBP. Sampling continued until thematic saturation was reached (n = 14). Data were analyzed using the Framework Method, so that data from multiple participants could be systematically summarized, compared, and analyzed. RESULTS: Four themes were identified: pain and helplessness, desire for validation, interactions with healthcare teams, and a return to pre-morbid identity and roles. Patients' initial presentation to hospital was characterized by severe pain, disability and difficulty in communicating their illness experience. Patients expected doctors to investigate for an underlying cause of the back pain. To recover, they were required to navigate a system they did not understand, interacting with healthcare workers who seemed to operate independently rather than as a team. Patients viewed medical treatment as a means of returning to pre-morbid activities of daily living, roles and relationships. Using these themes, a model of the inpatient journey was developed. CONCLUSION: We have described new patient insights which highlight how the hospital environment adds unique challenges to managing acute LBP. Several suggestions for acute LBP management guidelines are made: developing lay summaries for patients, including methods for communicating the team structure and roles to patients, and ensuring all members of treating teams are educated to ensure guidelines are consistently implemented.


Assuntos
Dor Aguda/psicologia , Prestação Integrada de Cuidados de Saúde , Dor Lombar/psicologia , Admissão do Paciente , Satisfação do Paciente , Dor Aguda/diagnóstico , Dor Aguda/fisiopatologia , Dor Aguda/terapia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Comunicação , Efeitos Psicossociais da Doença , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Dor Lombar/diagnóstico , Dor Lombar/fisiopatologia , Dor Lombar/terapia , Masculino , Pessoa de Meia-Idade , Percepção da Dor , Limiar da Dor , Equipe de Assistência ao Paciente , Relações Profissional-Paciente , Pesquisa Qualitativa , Recuperação de Função Fisiológica , Índice de Gravidade de Doença
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