What influences retrospective self-appraised recovery status among Danes with low-back problems? A comparative qualitative investigation.

Abstract

STUDY DESIGN: Phenomenological, qualitative investigation. The discord between commonly used outcome measures and patients' self-perceived recovery is problematic in the investigation and rehabilitation of low-back pain-related disorders. To better understand the course and development of this costly and disabling condition, the complex process of patient recovery requires further elucidation. OBJECTIVE: To explore issues and experiences impacting retrospective, self-appraised recovery. METHODS: Semi-structured interviews were conducted with 32 purposively sampled individuals, after which computer-assisted substantive categorization and thematic analysis was performed. RESULTS: Self-appraised status could be determined as "recovered" for 17 respondents, "unsure" for 6, and "not recovered" for 9. Recovery/non-recovery hinged on continued pain-related issues and the perception that injury/trauma made recovery impossible. Individuals who had difficulties relating the recovery construct to their context as well as those who were sceptical of pain-free periods were unable to appraise their status. CONCLUSION: This investigation confirms that pain is central to the resolution of recurrent low-back pain associated disorders. However, recovery also involves "redefinition" and "readjustment". In the investigation and rehabilitation of ambiguous, regional musculoskeletal disorders, our results provide further sensitizing concepts, derived through naturalistic observation, that are useful in the development of a more comprehensive explanatory framework of patient recovery.