De Souza Lorraine H, Frank Andrew O
Centre for Research in Rehabilitation, Brunel University, Middlesex, UK.
Disabil Rehabil. 2007 Apr 15;29(7):587-96. doi: 10.1080/09638280600925852.
Back-related functional limitations are largely assessed using lists of activities, each scored on a yes/no basis and the scores then summed. This provides little information about how chronic back pain (CBP) patients live with their condition. This study describes the consequences of living day-to-day with CBP and documents the 'insider' accounts of its impact on daily life.
Unstructured interviews, using the 'Framework' approach with topic guide, were recorded and transcribed verbatim. Subjects were sampled for age, sex, ethnicity and occupation from new referrals with back pain to a rheumatology outpatient clinic. Eleven subjects (5 male, 6 female) were interviewed either in English (n = 9) or their preferred language (n = 2). Interviews were read in-depth twice to identify the topics. Data were extracted in phrases and sentences using thematic content analysis.
Four themes emerged: sleep/rest, mobility, independence and leisure. All subjects reported issues about sleep and rest, nine about mobility, seven about independence and six on leisure. Most descriptions concerned loss and limitation in daily life. Strategies for coping with sleep disruption and physical limitations were described.
Subjects provided graphic 'in-depth' descriptions of experiences living with CBP every day; expressed regret at the loss of capabilities and distress at the functional consequences of those losses. Facilitating 'adjustment' to 'loss' may be more helpful than inferring the potential for a life free of pain as a result of therapeutic endeavours.
与背部相关的功能限制主要通过活动列表进行评估，每项活动按“是/否”计分，然后将分数相加。这几乎没有提供关于慢性背痛（CBP）患者如何应对自身病情的信息。本研究描述了CBP患者日常生活的后果，并记录了其对日常生活影响的“内部人士”描述。
采用“框架”方法和主题指南进行非结构化访谈，进行录音并逐字转录。从新转诊至风湿病门诊的背痛患者中，按年龄、性别、种族和职业进行抽样。11名受试者（5名男性，6名女性）接受了英语访谈（n = 9）或其首选语言访谈（n = 2）。访谈内容深入阅读两次以确定主题。使用主题内容分析法以短语和句子形式提取数据。
出现了四个主题：睡眠/休息、活动能力、独立性和休闲。所有受试者都报告了睡眠和休息方面的问题，9人提到了活动能力问题，7人提到了独立性问题，6人提到了休闲问题。大多数描述都涉及日常生活中的丧失和限制。描述了应对睡眠中断和身体限制的策略。
受试者生动地“深入”描述了每天与CBP共存的经历；对能力丧失表示遗憾，对这些丧失的功能后果感到痛苦。促进对“丧失”的“适应”可能比推断通过治疗努力实现无痛生活的可能性更有帮助。
