Centre for Health & Social Care Research, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
BMC Musculoskelet Disord. 2011 Oct 14;12:236. doi: 10.1186/1471-2474-12-236.
Individual illness perceptions have been highlighted as important influences on clinical outcomes for back pain. However, the illness perceptions of 'significant others' (spouse/partner/close family member) are rarely explored, particularly in relation to persistent back pain and work participation. The aim of this study was to initiate qualitative research in this area in order to further understand these wider influences on outcome.
Semi-structured interviews based on the chronic pain version of the Illness Perceptions Questionnaire-Revised were conducted with a convenience sample of UK disability benefit claimants, along with their significant others (n = 5 dyads). Data were analysed using template analysis.
Significant others shared, and perhaps further reinforced, claimants' unhelpful illness beliefs including fear of pain/re-injury associated with certain types of work and activity, and pessimism about the likelihood of return to work. In some cases, significant others appeared more resigned to the permanence and negative inevitable consequences of the claimant's back pain condition on work participation, and were more sceptical about the availability of suitable work and sympathy from employers. In their pursuit of authenticity, claimants were keen to stress their desire to work whilst emphasising how the severity and physical limitations of their condition prevented them from doing so. In this vein, and seemingly based on their perceptions of what makes a 'good' significant other, significant others acted as a 'witness to pain', supporting claimants' self-limiting behaviour and statements of incapacity, often responding with empathy and assistance. The beliefs and responses of significant others may also have been influenced by their own experience of chronic illness, thus participants lives were often intertwined and defined by illness.
The findings from this exploratory study reveal how others and wider social circumstances might contribute both to the propensity of persistent back pain and to its consequences. This is an area that has received little attention to date, and wider support of these findings may usefully inform the design of future intervention programmes aimed at restoring work participation.
个体的疾病认知被认为是影响背痛临床结果的重要因素。然而，“重要他人”（配偶/伴侣/亲密家庭成员）的疾病认知却很少被探讨，尤其是在持续性背痛和工作参与方面。本研究旨在对此领域进行定性研究，以进一步了解这些对结果的广泛影响。
采用慢性疼痛版疾病认知问卷修订版对英国残疾福利申请者及其重要他人（n=5 对）进行了基于半结构化访谈。使用模板分析对数据进行分析。
重要他人分享了，而且可能进一步强化了，申请人的无益疾病信念，包括对某些类型的工作和活动相关的疼痛/再受伤的恐惧，以及对重返工作岗位的可能性的悲观态度。在某些情况下，重要他人似乎对申请人背痛状况对工作参与的永久性和负面不可避免后果更为顺从，对合适工作的可用性和雇主的同情更为怀疑。在追求真实性的过程中，申请人渴望强调他们渴望工作，同时强调他们的病情的严重程度和身体限制使他们无法工作。在这方面，而且似乎基于他们对“好”重要他人的看法，重要他人充当了“疼痛见证者”，支持申请人的自我限制行为和无能力陈述，通常以同理心和帮助做出回应。重要他人的信念和反应也可能受到他们自己慢性疾病经历的影响，因此参与者的生活往往交织在一起，并由疾病定义。
这项探索性研究的结果揭示了他人和更广泛的社会环境如何既可能导致持续性背痛，又可能导致其后果。这是一个迄今为止关注甚少的领域，对这些发现的更广泛支持可能有助于为旨在恢复工作参与的未来干预计划的设计提供信息。
