Patients' experiences of how symptoms are explained and influences on back-related health after pre-surgery physiotherapy : A qualitative study

BACKGROUND: Since the pre-surgery phase is a new setting for physiotherapy, exploring patients' experiences might contribute to new insights for future development of care in patients with degenerative lumbar spine disorders. OBJECTIVES: To describe patients' experiences of how symptoms are explained, and their experiences of the influences on back-related health after pre-surgery physiotherapy. DESIGN: Explorative qualitative design using semi-structured interviews analysed with content analysis. PARTICIPANTS: Eighteen patients with degenerative lumbar spine disorder scheduled for surgery, participated in pre-surgery physiotherapy. FINDINGS: Five categories were identified: Influences on symptoms, physical function and sleep; Influences on coping and well-being; Explanations of back-related symptoms and wanting to be well-informed; Influence on social functioning; The ability of the model of care to influence reassurance and prevention. CONCLUSION: Improvements in back-related health in all the biopsychosocial dimensions emerged. Even those who expressed no symptom improvements, felt better performing exercises than being inactive, and exercises improved their frame of mind, a useful experience in possible low back pain recurrences. Pre-surgery physiotherapy provided reassurance and gave time to reflect on treatments and lifestyle. Despite pre-surgery physiotherapy, back-related symptoms were mainly described in line with a biomedical explanatory model. Those using broader explanations were confident that physiotherapy and self-management could influence their symptoms. Suggesting more emphasis on explanatory models suitable for surgery, pre- and post-surgery physiotherapy and self-management in the professionals' dialogue with patients.This article had the status submitted when included in the thesis with the title "Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders" and the permanent link http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-150553.Funding agencies: County Council of Ostergotland, Linkoping, Sweden