title: Back pain - a feeling of being mistrusted and lack of recognition: a qualitative study.
abstract: BACKGROUND
  Research shows that suffering from back pain can be associated with great personal costs and that patients undergoing spinal fusion surgery experience particularly problematic illness trajectories and struggle with existential challenges related to living with pain for many years.
  
  
  OBJECTIVE
  This study aims to explore how patients with back pain experience their illness trajectories and their interaction with the healthcare system.
  
  
  METHODS
  Data were collected through observations and semi-structured interviews. Data analysis was based on the French philosopher Paul Ricoeur's phenomenological hermeneutic theory of interpretation.
  
  
  RESULTS
  Before the spinal fusion surgery, back pain had a great negative influence on the patients' everyday lives. Insinuations of being a hypochondriac and having to hide their pain to avoid becoming a burden caused insecurity. Several patients experienced pain relieving effect when talking about their experiences. However, they felt that the healthcare professionals were pressed for time and were mainly interested in their physiological problems. Patients were left with a feeling of being mistrusted, powerlessness, insecurity and loss of identity.
  
  
  CONCLUSIONS
  Lifeworld-experiences are not given priority when dealing with patients suffering from back pain. To accommodate individual needs, aspects related to the patients' experiences of their illness trajectories should be taken into account regarding patient communication.
authors.affiliation: Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Regional Hospital Central, Jutland, Denmark; Section for Nursing, Department of Public Health, Aarhus University & Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Regional Hospital Central Jutland, Denmark. Electronic address: jannedamsgaard@webspeed.dk.
authors.forename: Janne B
authors.initials: JB
authors.lastname: Damsgaard
authors.affiliation: Section for Nursing, Department of Public Health, Aarhus University/Health, VIA University College, Aarhus, Denmark.
authors.forename: Annelise
authors.initials: A
authors.lastname: Norlyk
authors.affiliation: Section for Nursing, Department of Public Health, Aarhus University/Health, Aarhus, Denmark; Elective Surgery Centre, Silkeborg Regional Hospital, Regional Hospital Central, Jutland, Denmark.
authors.forename: Lene B
authors.initials: LB
authors.lastname: Jørgensen
authors.affiliation: Lillebaelt Hospital, Vejle & Institute of Regional Health Research, University of Southern Denmark, Denmark.
authors.forename: Regner
authors.initials: R
authors.lastname: Birkelund
mesh_terms: D001416:Back Pain / Q000523:psychology*; D017281:Cost of Illness; D005086:Existentialism / Q000523:psychology*; D006801:Humans; D055809:Illness Behavior; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*
keywords: Back pain; Being mistrusted; Communication; Invisibility; Psychosocial; Recognition; Spinal fusion surgery