Background
Methods
Participants
Sampling
Data collection and interviews
Data analysis
Results
Characteristic | |
---|---|
English as a first language, n (%) | 13 (92.9) |
Born in Australia, n (%) | 7 (50.0) |
Highest education level achieved, n (%) | |
Year 10 or less | 2 (14.3) |
TAFE / Vocational college | 1 (7.1) |
Year 12 | 4 (28.6) |
University qualification | 7 (50.0) |
Currently employed, n (%) | 6 (42.9) |
Access to an Australian Healthcare card^, n (%) | 7 (50.0) |
Current insurance claim for injury, n (%) | 1 (7.1) |
Have consulted a health professional for LBP, n (%) | 14 (100.0) |
Average LBP intensity measured by NRS‡, mean (SD), min-max. | |
Current | 2.9 (2.8), 0-8 |
In the last week | 5.2 (2.6), 1-9 |
In the last month | 5.1 (2.1), 2-8 |
Satisfaction with forum measured by GPIU† NRS, mean (SD), min-max | 6.5 (3.0), 0-10 |
Poor access to information and services in rural settings
"“… [services or information available] nothing, nothing at all! I don’t even know where to look, you know, I mean I ask around and nobody seems to know.” (Female participant (KA1), Kalgoorlie)""“Well the information is just not there; it’s not available. Or, I suppose it is, if you know where to look, but there is nobody saying anything, giving you a pamphlet, and saying this is where you go for support services, so I don’t even know what is available in Albany.” (Female participant (AL1), Albany)"
"“… he [allied health practitioner] lives at the end of our street and I walk past him all the time and you know how you get referred to people by friends, well he has a really good name by lots of sports people that we know.” (Female participant (KA5), Kalgoorlie)"
"“I have asked people my own age group what is what, and where to get a doctor, and all that sort of thing, and what’s up there, what do you get up at the hospital, and that sort of thing, and people, the ones I have asked, they don’t know.” (Female participant (KA1), Kalgoorlie)"
" “ Well I’m in a pretty remote area where there are no services at all basically. There has been a GP service here for the last 2 years, before that it would only be the Kununurra hospital and they were pretty much emergency treatment only.” (Male participant (KU2), Kununurra)""“I still find dealing with the GP quite difficult, quibbling if you want pain relief and things like that. I certainly have got some medication, but I feel like it’s very reluctantly given.” (Female participant (AL5), Albany)"
Inadequate knowledge and skills among local practitioners
"“We often get first year grads and I know first year grads are excited and full of information but they often don’t have the experience.” (Female participant (KA5), Kalgoorlie)""“Look, I love my GP, he is really good, but he is not a pain specialist. He is not, not skilled in pain, but he is just not up to date in everything to do with pain, because pain is now really becoming a discipline in its own right.” (Male participant (KA2), Kalgoorlie)"" “ It’s not derogatory on them, it’s just that they don’t know back pain as a specialty, it’s just that they are always under pressure, they are always under-staffed and under pressure and it is always the new recruits who come out to the country areas and none of them have specialist experience in back pain.” (Male participant (KA2), Kalgoorlie)"
"“It all depends on your doctor, which is very frustrating. You go to a certain GP and they will put you on a Patient Assisted Transport form and they will fly you because of pain, and not wanting to sit on a train for seven hours, but it depends on your GP, which it shouldn’t.” (Female participant (KA5), Kalgoorlie)""“… it took me a long time, probably 18 months, which sounds dreadful, to find a GP that would listen and knew that you were real, because you know, pain is very difficult to pinpoint.” (Female participant (KA5), Kalgoorlie)""It’s not like having an arm in a sling, or something, so people can be prepared. If they can see it, or if you walk with a bit of a limp or something like that, or crutches, people are a bit more sympathetic.” (Female participant (AL3), Albany)"
"“Something I have always found quite difficult is getting reliable information or guidance about managing pain in a kind of holistic sense. I can go to a physio, I can go to a chiropractor, I can go to a doctor, I can take medication, and obviously I can search on the internet, but trying to work out how things come together has always been a bit of a problem.” (Female participant (AL2), Albany)""“I just found that the doctors were fairly inclined to say, you know that there are people worse off than you, you’ll be alright or alternatively prescribe stronger and stronger pain killers, which is not what I want. I wasn’t saying that I need pain killers, I was saying that I need to know how to start getting a management plan together, that sort of response is not helpful at all for me.” (Female participant (AL2), Albany)""“What I would have liked from my GP in the first instance was perhaps a suggestion then to talk to an OT [occupational therapist], to use various parts of your body to not put undue stress on your joints; maybe a suggestion, I don’t know, whether there is an arthritis nurse or something like that locally. Just something, so I knew the GP was hearing my concerns and was helping me with a management plan.” (Female participant (AL2), Albany)"
Feelings of isolation and frustration
"“These sorts of remote areas, they are for fit young people you know, not for silly old military veterans like me. It’s not a disabled veteran’s sort of country. It’s purely an area for young people”. (Male participant (KU2), Kununurra)""“There is a lady here who has to fly down to Perth every two weeks or something, it’s just not an area where that sort of thing [health infrastructure] is realistic you know”. (Male participant (KU2), Kununurra)"
"“It’s frustrating because for like a pump refill I need to fly down in the morning [to Perth], I have to go to xxxx street, the pharmacy that makes up the script, then go to Dr X’s rooms, then wait until lunchtime and then get him to do the pump refill and then go back to the airport and sit around for 4 or 5 hours until the plane is ready to go. So, it’s frustrating, it takes a whole day to do a 15 minute thing!” (Male participant (KA2), Kalgoorlie)""“. it [travelling to Perth] still means time off for my husband who has got to take leave [from work]. For the last few years the only holiday we have taken together is all to go to Perth together. 700km in the car is not that much fun with little ones.”(Female participant (KA5), Kalgoorlie).""“…you have to pay your own accommodation and cos’ I can’t drive that distance I have to pay for my flights down and my own accommodation and all that sort of thing.” (Male participant (KA2), Kalgoorlie)"
"“Specialist treatment is pretty much non-existent. You have to wait two or three months for a visiting specialist or get yourself off to Darwin or Perth or somewhere, or some major centre” (Male participant (KU2), Kununurra)""“I call him up [pain specialist] and the secretary says you have to make an appointment and I say I just want to talk to him, I don’t need to see him. That is tricky with pain, because you can talk on the telephone, because you don’t need to be examined, so that [telemedicine] would be nice.” (Female participant (KA5), Kalgoorlie)"
Competing lifestyle demands hindering effective self-management for CLBP
"“… it’s just trying to access [the pool]; I have a little one so it’s just getting out and finding the time to do these things.” (Female participant (KA5), Kalgoorlie)""“I like doing them [stretches and exercises], and I know I have to, but sometimes it is just like, you come home from work and you’ve got to feed the dogs, and make some food and do the dishes and then its bed time.” (Female participant (KU3), Kununurra)"
"“… some people, they have to just get these things done, and they don’t have the option to [pace].” (Female participant (KU3), Kununurra)""“….not pushing through your pain which is the most USELESS advice you can give to anybody because you have to push through the pain just to survive unless you live in a nursing home where somebody does everything for you.” (Female participant (AL1), Albany)"
Psychological burden associated with CLBP
"“… the fact that it is not just pain, it affects you in every single way because it is constant pain so it affects you psychologically too because you waste so much time going to doctors and specialists and on medication…” (Female participant (KA5), Kalgoorlie)""“… it [the body] all seems to be, you know, falling apart at this time in my life. It is frustrating because when I came here [rural site] I really wanted to get out into the community and do something. I thought even last night, what can I do? It has to be something sitting down, you know, it’s frustrating.” (Female participant (KA1), Kalgoorlie)"