Article

PURPOSE: To explore the differences in narrative between patients with persistent
non-specific low back pain (PLBP) who benefited from a pain management programme,
and those who did not benefit. METHOD: We conducted interviews with 20 patients
attending a pain management programme; prior to attending the programme,
immediately following the programme and at one year.
Our analysis focused on a
theoretical sample of patients who either described dramatic life improvements at
one year, and who described themselves as much worse. We used the methods of
grounded theory. RESULTS: We found that finding hope was central to good outcome.
Patients restored hope by making certain changes; (a) deconstructing specific
fears, (b) constructing an acceptable explanatory model (c) reconstructing self
identity by making acceptable changes. Those who had not restored hope retained
fears of loss of self, remained committed to the biomedical model and were unable
to make acceptable changes. CONCLUSIONS: Our findings may help to operationalise
the restoration of hope in patients with PLBP. Firstly, health care professionals
need to identify and resolve any specific fears of movement. Secondly, patients
need an acceptable explanatory model that fits their experience and personal
narrative. Finally our study confirms the centrality of self concept to recovery.

Langue : ANGLAIS