Clinical encounters may not be responding to patients’ search for meaning and control over non-specific chronic low back pain – an interpretative phenomenological analysis

Abstract

Purpose

Considering the need to study the experiences of individuals with musculoskeletal problems in contexts that have not yet been investigated as well as the relevance of fostering a research agenda towards person-centred care, this study aimed to explore the experiences of non-specific chronic low back pain from the perspective of Portuguese individuals living with it.

Material and methods

An interpretative phenomenological analysis was employed to explore the experiences of eight participants, who were recruited purposefully from two primary care centres and one clinic. Semi-structured one-to-one interviews were carried out, audio-recorded and transcribed verbatim.

Results

Three themes were generated as interrelated parts of an extended account that explored the participants’ meaning making of their experience: “Non-specific chronic low back pain as a disruptive experience”; “Searching for the meaning of non-specific chronic low back pain”; and, “Clinical encounters that perpetuate the lack of understanding about non-specific chronic low back pain.”

Conclusions

This study offers insight into the Portuguese individuals’ experiences of non-specific chronic low back pain. Particularly, it suggests that clinical encounters may not be aligned with patients’ needs and expectations. These findings may help clinicians in transferring this knowledge to therapeutic approaches to individuals with similar experiences/contexts.

IMPLICATIONS FOR REHABILITATION

• Patients with NSCLBP need to understand their pain and to retain a sense of control over their lives.

• Encounters with health professionals may perpetuate the lack of understanding about pain and strategies to control it, as patients consider themselves unable to have an active role in the decision-making and are disempowered to deal with their pain.

• Health professionals should involve patients and promote the co-construction of an explanation that integrates both health professionals’ knowledge and patients’ narratives.

• There is a need to align both the patients’ and health professionals’ perspectives regarding health care in order to implement patient-centred and individually tailored treatment.

Keywords:

• Non-specific chronic low back pain
• patient experience
• patient-centred care
• interpretative phenomenological analysis
• qualitative research

Acknowledgements

The authors gratefully acknowledge the individuals who agreed to participate in this study for generously and bravely sharing their stories and the physiotherapists and health institutions that collaborated with this research. Acknowledgements are also extended to Dr. Alexandra Costa for her work as a certified bilingual translator.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Figure 1. Interview schedule.

Additional information

Funding

This work was supported by the Polytechnic Institute of Setúbal [PhD Grant reference: SFRH/PROTEC/67839/2010].