Immediate patient perceptions following lumbar spinal fusion surgery: semi-structured multi-centre interviews exploring the patient journey and experiences of lumbar fusion surgery (FuJourn),European Spine Journal

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Immediate patient perceptions following lumbar spinal fusion surgery: semi-structured multi-centre interviews exploring the patient journey and experiences of lumbar fusion surgery (FuJourn)
European Spine Journal ( IF 2.6 ) Pub Date : 2022-09-17 , DOI: 10.1007/s00586-022-07381-x
Alison Rushton _{1,

2} , Bini Elena ₂ , Feroz Jadhakhan ₂ , Annabel Masson ₂ , J Bart Staal ₃ , Martin L Verra ₄ , Andrew Emms ₅ , Michael Reddington ₆ , Ashley Cole ₇ , Paul C Willems ₈ , Lorin Benneker ₉ , Nicola R Heneghan ₂ , Andrew Soundy ₁₀

Affiliation

School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Physiotherapy, Bern University Hospital, Insel Group, Bern, Switzerland.
Department of Physiotherapy, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Department of Physiotherapy, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
Department of Orthopaedics & Trauma, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.
Maastricht University Medical Centre, Maastricht, The Netherlands.
Department of Orthopaedic Surgery Inselspital, University of Bern, Bern, Switzerland.
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.

Purpose

To understand the patient journey to Lumbar Spinal Fusion Surgery (LSFS) and patients’ experiences of surgery.

Methods

Qualitative study using interpretive phenomenological analysis. Adult participants following LSFS were recruited from 4 UK clinical sites using purposive sampling to ensure representation of key features (e.g. age). Semi-structured interviews informed by a piloted topic guide developed from the literature were audio-recorded and transcribed verbatim. Framework analysis for individual interviews and then across participants (deductive and inductive) identified emerging themes. Trustworthiness of data analyses was enhanced using multiple strategies (e.g. attention to negative cases).

Results

Four emerging themes from n = 31 patients’ narratives were identified: decision for surgery, coping strategies, barriers to recovery and recovery after surgery. Decision for surgery and recovery after surgery themes are distinguished by the point of surgery. However, barriers to recovery and coping strategies are key to the whole patient journey encompassing long journeys to surgery and their initial journey after surgery. The themes of coping strategies and barriers to recovery were inter-related and perceived by participants as parallel concepts. The 4 multifactorial themes interacted with each other and shaped the process of an individual patient’s recovery. Factors such as sporadic interventions prior to surgery, time-consuming wait for diagnosis and surgery and lack of information regarding recovery strongly influenced perceptions of outcome.

Conclusion

Patient driven data enables insights to inform research regarding surgery/rehabilitation through depth of understanding of the patient journey. Awareness of factors important to patients is important; ensuring that patient-driven data informs research and patient care.

中文翻译：

腰椎融合手术后患者的即时感受：半结构化多中心访谈探索腰椎融合手术患者的旅程和经验 (FuJourn)

目的

了解患者接受腰椎融合手术 (LSFS) 的过程以及患者的手术体验。

方法

使用解释现象学分析的定性研究。LSFS 之后的成人参与者是从 4 个英国临床站点招募的，使用有目的的抽样来确保关键特征（例如年龄）的代表性。半结构化访谈由根据文献开发的试点主题指南提供信息，并被录音并逐字转录。个人访谈的框架分析，然后跨参与者（演绎和归纳）确定了新出现的主题。使用多种策略（例如关注负面案例）增强了数据分析的可信度。

结果

n的四个新兴主题 = 确定了 31 名患者的叙述：手术决定、应对策略、恢复障碍和手术后恢复。手术决定和手术后恢复主题是根据手术点来区分的。然而，康复障碍和应对策略是整个患者旅程的关键，包括漫长的手术旅程和手术后的初始旅程。应对策略和恢复障碍的主题相互关联，并被参与者视为平行概念。4 个多因素主题相互影响，塑造了个体患者的康复过程。手术前的零星干预、等待诊断和手术的耗时以及缺乏有关恢复的信息等因素强烈影响了对结果的看法。