Acknowledging the back patient: A thematic synthesis of Qualitative research. A systematic literature review

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Acknowledging The Back Patient. A Thematic Synthesis Of Qualitative Research. A Systematic Literature Review.
Janne Brammer Damsgaard1, Lene Bastrup Jørgensen1, Annelise Norlyk2, Regner Birkelund3
1. Health, Section for Nursing, Aarhus University & Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Regional Hospital Central Jutland, Silkeborg, Denmark
2. Health, Section for Nursing, Aarhus University, Aarhus, Denmark
3. University of Southern Denmark & Vejle Sygehus, Vejle, Denmark

keywords:Back Patient, Narrative, Biomedical, Marginalisation, Self-Identity, Ethical Responsibility, Acknowledgement
Introduction: Back conditions and back pain rank among the most common causes of reduced working capacity and lengthy, challenging and costly illness trajectories. According to international research, back conditions rank among the costliest conditions worldwide. A thorough review of the literature in the field has further revealed that back conditions are associated with heavy personal costs. It is therefore of utmost importance that these conditions are dealt with as efficiently and effectively as possible as failure to do so can have severe implications for society as a whole.
In order to gain a better idea of the most ideal treatment process, it is important to first investigate what it feels like to be a back patient and what patients consider important when dealing with the healthcare system.
It is the aim of this qualitative literature review based on thematic synthesis to shed more light on these two particular areas.
Objectives: The objective of this literature review is to get a deeper understanding of the illness trajectory for back patients.

Thus, the literature review therefore seeks to locate, systematise and synthesize findings derived from qualitative research in order to visualise barriers or implications for intervention development.
Methods: The method draws on James Thomas' and Angela Hardens article "Methods for the thematic synthesis of qualitative research in systematic reviews". The thematic synthesis aims to systematise and integrate findings of qualitative studies. The synthesis takes form of three stages which overlaps to some degree: the free "line by line coding" of the findings of primary studies; the organzation of these "free codes" into related areas to construct "descriptive themes" and the development of "analytical themes".
The integrations are more than the sum of parts, in that they offer novel interpretations and findings. These interpretations will not be found in any one research report but, rather, are inferences derived from taking all the reports in a sample as a whole.
Results: The thematic analysis reveals that many back patients feel that their experiences and perceptions are ignored by the health professionals, who are often concerned about identifying the cause. This can result in patients feeling mistrusted, marginalized and reluctant to speak out.
It is through telling other people about our experiences that we create an awareness of ourselves. Therefore, telling about experiences and perceptions is important for back patients in order to feel accepted and acknowledged. But selfhood cannot be reduced to narrative identity since the identity of the self is only fully revealed the moment we include the ethical dimension including certain norms and binding. Thus, in order to acknowledge the back patient, it is important for the health professionals to be somebody the back patients can count on. The health professionals must incorporate the patients' narratives as an integral part of the care and treatment.
Conclusions: In order to acknowledge the back patient the narrative must be complemented by a different perspective that includes the issue of ethical responsibility. It is therefore also a question of adopting certain norms as binding; to be bound by obligation or loyalty. Thus, the literature review argue for a more process-oriented patient approach that incorporates patients' narratives as an integral part of the care and treatment.

Original languageEnglish
Publication year4 Jun 2014
Number of pages2
Publication statusPublished - 4 Jun 2014
Event15 th EFORT Congress 2014 - ExCel, London, London, United Kingdom
Duration: 4 Jun 20146 Jun 2014

Conference

Conference15 th EFORT Congress 2014
LocationExCel, London
CountryUnited Kingdom
CityLondon
Period04/06/201406/06/2014

    Research areas

  • back patient, narrative, biomedical, marginalisation, self-identity, ethical responsibility, acknowledgement

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