‘I Have Never Been in That Kind of All-Consuming Pain … I Did Not Know What Else to Do’: The Journey to Hospital Admission With Low Back Pain From the Perspectives of Patients

Abstract

Background

There is a need to better understand patient factors contributing to low back pain (LBP)-related hospitalisations to improve health service delivery and reduce avoidable admissions.

Objective

This study explored the experiences of people with LBP leading up to and resulting in hospital admission.

Design

Qualitative descriptive methodology using semi-structured interviews.

Setting and Participants

Patients admitted with non-specific LBP at a large Australian tertiary public hospital meeting specific inclusion and exclusion criteria were pragmatically identified and recruited, and they consented to participate. Interviews were audio-recorded, and thematic analysis generated codes and themes from the data.

Results

Sixteen patients consented to participate. The cohort had an average age of 52 years (SD = 17) and had an average hospital length of stay of 13 days (SD = 10.8, range = 2–31). Two themes were identified. The first related to the impact of LBP on patients' lives, with sub-themes including difficulty coping with pain, difficulty managing daily activities and escalating distress. The second theme related to unmet treatment needs, with sub-themes including ineffectiveness of past treatments, inability to access timely and affordable community healthcare, and expectations for emergency care.

Conclusion

Patients impacted by severe LBP regarded hospitals as a last resort for management of pain when community healthcare was perceived to be ineffective or inaccessible. This study highlights the practice gaps before hospitalisation for LBP from the perspectives of patients and the need to improve the delivery and access of healthcare for this condition.

Patient or Public Contribution

This study sought insights from patients with low back pain (LBP) who were admitted to hospital with LBP. The findings will inform stakeholders, including consumers, on the co-design of an optimal system of care to improve the delivery and access of health services for LBP. All patients were offered the opportunity to review a summary of the study's results.