McCluskey Serena, Brooks Joanna, King Nigel, Burton Kim
Centre for Health and Social Care Research, Institute for Research in Citizenship and Applied Human Sciences, University of Huddersfield, Huddersfield, West Yorkshire, UK.
Centre for Applied Psychological Research, Institute for Research in Citizenship and Applied Human Sciences, University of Huddersfield, Huddersfield, West Yorkshire, UK.
Work. 2014;48(3):391-8. doi: 10.3233/WOR-131789.
Treatment expectations form a fundamental component of the self-regulatory model of health behavior, which defines such cognitions as illness perceptions. Unrealistic and/or unhelpful treatment expectations have been linked to detrimental clinical and work outcomes in those with persistent low back pain. However, research of this nature has rarely focused on the influence of 'significant others' (spouse/partner/close family member).
To provide an in-depth examination of the treatment expectations of the 'significant others' of individuals who have become unable to work due to persistent low back pain, highlighting how significant others may influence recovery and work participation outcomes for such individuals.
A convenience sample (n=18) of work disability benefit claimants and their significant others were recruited from two settings in the North of England.
A qualitative research design was employed, and semi-structured interviews based on the chronic pain version of the Illness Perceptions Questionnaire-Revised were conducted with claimants and their significant others. Interview data were analysed using template analysis.
It was found that significant others expected a substantial reduction or complete removal of pain in order for treatment to be considered successful. The pursuit of diagnostic tests was important in validating such expectations, and there was continued scepticism of treatments already undertaken or offered as an alternative. Like the individuals affected, significant others believed that a correct diagnosis had not yet been received, which led to a continued delay in return to work.
This study demonstrates that significant others have similar unrealistic and/or unhelpful treatment expectations to those widely reported by individuals with persistent low back pain, and could further reinforce such illness perceptions and serve as wider psychosocial obstacles to recovery and continued work participation.
治疗期望构成了健康行为自我调节模型的基本组成部分，该模型将诸如疾病认知等认知定义其中。不切实际和/或无益的治疗期望与持续性腰痛患者的不良临床和工作结果相关。然而，这类研究很少关注“重要他人”（配偶/伴侣/亲密家庭成员）的影响。
深入研究因持续性腰痛而无法工作的个体的“重要他人”的治疗期望，突出重要他人可能如何影响此类个体的康复和工作参与结果。
从英格兰北部的两个地点招募了工作残疾福利申领者及其重要他人的便利样本（n = 18）。
采用定性研究设计，对申领者及其重要他人进行基于修订后的疾病认知问卷慢性疼痛版的半结构化访谈。访谈数据采用模板分析法进行分析。
发现重要他人期望疼痛大幅减轻或完全消除，才会认为治疗成功。寻求诊断测试对于验证此类期望很重要，并且对已经进行或作为替代方案提供的治疗仍持怀疑态度。与受影响的个体一样，重要他人认为尚未得到正确诊断，这导致重返工作岗位持续延迟。
本研究表明，重要他人与持续性腰痛患者广泛报告的不切实际和/或无益的治疗期望相似，并且可能进一步强化此类疾病认知，并成为康复和持续工作参与的更广泛的社会心理障碍。
