Singh Gurpreet, Newton Christopher, O'Sullivan Kieran, Soundy Andrew, Heneghan Nicola R
Musculoskeletal Physiotherapy Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
BMJ Open. 2018 Feb 11;8(2):e020108. doi: 10.1136/bmjopen-2017-020108.
Disabling chronic low back pain (CLBP) is associated with negative beliefs and behaviours, which are influenced by culture, religion and interactions with healthcare practitioners (HCPs). In the UK, HCPs encounter people from different cultures and ethnic backgrounds, with South Asian Indians (including Punjabis) forming the largest ethnic minority group. Better understanding of the beliefs and experiences of ethnic minorities with CLBP might inform effective management.
To explore the CLBP beliefs and experiences of English-speaking Punjabi and white British people living with CLBP, explore how beliefs may influence the lived experience of CLBP and conduct cross-cultural comparisons between the two groups.
Qualitative study using semistructured interviews set within an interpretive description framework and thematic analysis.
A National Health Service hospital physiotherapy department, Leicester, UK.
10 CLBP participants (5 English-speaking Punjabi and 5 white British) purposively recruited from physiotherapy waiting lists.
Participants from both groups held negative biomedical CLBP beliefs such as the 'spine is weak', experienced unfulfilling interactions with HCPs commonly due to a perceived lack of support and negative psychosocial dimensions of CLBP with most participants catastrophising about their CLBP. Specific findings to Punjabi participants included (1) disruption to cultural-religious well-being, as well as (2) a perceived lack of understanding and empathy regarding their CLBP from the Punjabi community. In contrast to their white British counterparts, Punjabi participants reported initially using passive coping strategies; however, all participants reported a transition towards active coping strategies.
CLBP beliefs and experiences, irrespective of ethnicity, were primarily biomedically orientated. However, cross-cultural differences included cultural-religious well-being, the community response to CLBP experienced by Punjabi participants and coping styles. These findings might help inform management of people with CLBP.
致残性慢性下腰痛（CLBP）与消极信念和行为有关，这些信念和行为受到文化、宗教以及与医护人员（HCPs）互动的影响。在英国，医护人员会接触到来自不同文化和种族背景的人，其中南亚印度人（包括旁遮普人）是最大的少数族裔群体。更好地了解患有CLBP的少数族裔的信念和经历可能有助于进行有效的管理。
探讨讲英语的旁遮普人和患有CLBP的英国白人对CLBP的信念和经历，探究这些信念如何影响CLBP的生活体验，并对两组进行跨文化比较。
采用定性研究方法，在解释性描述框架内进行半结构化访谈，并进行主题分析。
英国莱斯特的一家国民保健服务医院理疗科。
从理疗候诊名单中有意招募了10名CLBP患者（5名讲英语的旁遮普人和5名英国白人）。
两组参与者都持有消极的生物医学CLBP信念，如“脊柱脆弱”，他们与医护人员的互动往往不尽人意，这通常是由于感觉缺乏支持以及CLBP的消极心理社会层面，大多数参与者对自己的CLBP感到极度担忧。旁遮普参与者的具体发现包括：（1）文化宗教幸福感受到干扰，以及（2）旁遮普社区对他们的CLBP缺乏理解和同理心。与英国白人参与者不同，旁遮普参与者最初报告使用被动应对策略；然而，所有参与者都报告了向积极应对策略的转变。
无论种族如何，CLBP的信念和经历主要以生物医学为导向。然而，跨文化差异包括文化宗教幸福感、旁遮普参与者所经历的社区对CLBP的反应以及应对方式。这些发现可能有助于为CLBP患者的管理提供参考。
