title: The experience of patients admitted to hospital with acute low back pain: a qualitative study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.|Department of Rheumatology, Liverpool Hospital, Sydney, New South Wales, Australia.
authors.forename: Carlos
authors.identifier: http://orcid.org/0000-0003-1159-2323
authors.initials: C
authors.lastname: El-Haddad
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Arvin
authors.initials: A
authors.lastname: Damodaran
authors.affiliation: Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Patrick McNeil
authors.affiliation: School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Hu
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003142:Communication; D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D058748:Pain Perception; D017288:Pain Threshold; D010343:Patient Admission; D010348:Patient Care Team; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D036301:Qualitative Research; D020127:Recovery of Function; D012720:Severity of Illness Index
keywords: clinical aspects < soft tissue rheumatism and regional pain syndromes; education < soft tissue rheumatism and regional pain syndromes; low back pain; patient experience; qualitative research