Alsaif Hanan, Goodwin Peter C, Callaghan Michael J, Sudell Lindsay, O'Neill Terence W, Yeowell Gillian
Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Physiotherapy, King Fahad Military Medical Complex - KFMMC Dhahran, Kingdom of Saudi Arabia.
Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Health and Professions, Manchester Metropolitan University, Manchester, United Kingdom.
Musculoskelet Sci Pract. 2023 Apr;64:102740. doi: 10.1016/j.msksp.2023.102740. Epub 2023 Mar 15.
Lumbar disc disease is a leading cause of low back pain. Lumbar discectomy (LD) may be indicated if symptoms are not managed conservatively. Rehabilitation has traditionally been delivered postoperatively; however, there is increasing delivery preoperatively. There are few data concerning perceptions and experiences of preoperative rehabilitation. Exploring experiences of preoperative rehabilitation may help in the development and delivery of effective care for patients.
To develop an understanding of patient and healthcare provider (HCP) experiences, perspectives and preferences of preoperative LD rehabilitation, including why patients do not attend.
A qualitative interpretive approach using focus groups and individual interviews.
Data were collected from; a) patients listed for surgery and attended the preoperative rehabilitation (October 2019 to March 2020), b) patients listed for surgery but did not attend rehabilitation, and c) HCPs involved in the delivery of rehabilitation. Data were transcribed verbatim and analysed using thematic analysis.
RESULTS/FINDINGS: Twenty participants were included, twelve patients and eight HCPs. The preoperative class was a valuable service for both patients and HCPs. It provided a solution to staffing and time pressures. It provided the required education and exercise content helping the patients along their surgery pathway. Travel distance, transportation links, parking difficulty and cost, lack of knowledge about the class aims, and previous negative experiences were barriers to patient attendance.
For most patients and HCPs, the preoperative class was valuable. Addressing the challenges and barriers could improve attendance. Future research should focus on management of patient expectations and preferences preoperatively.
腰椎间盘疾病是下腰痛的主要原因。如果症状无法通过保守治疗得到控制，可能需要进行腰椎间盘切除术（LD）。传统上，康复治疗是在术后进行的；然而，术前进行康复治疗的情况越来越多。关于术前康复治疗的认知和体验的数据很少。探索术前康复治疗的体验可能有助于为患者制定和提供有效的护理。
了解患者和医疗保健提供者（HCP）对术前LD康复治疗的体验、观点和偏好，包括患者不参加的原因。
采用焦点小组和个人访谈的定性解释方法。
收集以下数据：a）列入手术名单并参加术前康复治疗的患者（2019年10月至2020年3月），b）列入手术名单但未参加康复治疗的患者，以及c）参与康复治疗的HCP。数据逐字转录并使用主题分析进行分析。
结果/发现：共纳入20名参与者，12名患者和8名HCP。术前课程对患者和HCP来说都是一项有价值的服务。它解决了人员配备和时间压力问题。它提供了所需的教育和锻炼内容，帮助患者顺利完成手术。出行距离、交通连接、停车困难和成本、对课程目标缺乏了解以及以前的负面经历是患者参加的障碍。
对大多数患者和HCP来说，术前课程是有价值的。解决这些挑战和障碍可以提高参与率。未来的研究应侧重于术前对患者期望和偏好的管理。
