Abstract
Objectives
The purpose of this qualitative metasynthesis is to articulate the knowledge gained from a review of qualitative studies of patients’ experiences of chronic low back pain.
Methods
Meta-ethnographic methodology guided the review of 33 articles representing 28 studies published in English in peer-reviewed journals between 2000 and 2012. A systematic comparison of the main themes from each study was conducted and ‘synthesised’ to create superordinate themes.
Results
Three overarching interrelated themes were identified: the impact of chronic low back pain on self; relationships with significant others that incorporated two streams – health professionals and the organisation of care and relationships with family and friends; coping with chronic low back pain. Coping strategies were predominantly physical therapies, medication and avoidance behaviours with very few successful strategies reported. Professional and family support, self-efficacy, motivation, work conditions and exercise opportunities influenced pain experiences. Review authors’ recommendations included psychological therapies, education, the facilitation of self-management strategies and support groups.
Discussion
The review substantiates chronic low back pain as complex, dynamic and multidimensional, underpinned by experiences of persistent distressing pain, loss, and lowered self-worth, stigma, depression, premature aging, fear of the future. Future research should address the paucity of longitudinal studies, loss and issues of ethnicity, gender, ageing.
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