Between hope and fear: A qualitative study on perioperative experiences and coping of patients after lumbar fusion surgery

Int J Orthop Trauma Nurs. 2019 Nov:35:100707. doi: 10.1016/j.ijotn.2019.07.003. Epub 2019 Jul 8.

Abstract

Objective: Recovery following lumbar fusion surgery is frequently accompanied by post-operative pain, and patients often continue to experience some level of chronic pain. There is a scarcity of qualitative research focusing on patient experiences regarding lumbar fusion surgery. This study aims to clarify how lumbar fusion surgery patients experience the perioperative period; their hopes, their post-operative pain experiences, their fluctuating physical condition and accompanying emotions.

Methods: Semi-structured interviews were conducted with 12 lumbar fusion surgery patients. Transcripts of these interviews were open and axial coded by two coders using Atlas.ti software and Thematic Analysis.

Results: A total of thirteen categories and four overarching themes were generated from the data. Participants described their beliefs and experiences surrounding surgery, including a long preoperative illness process, tumultuous recovery and unfulfilled preoperative expectations. Participants used various forms of pain coping including activity avoidance and endurance, and emotion regulation strategies such as acceptance.

Conclusion: This study demonstrates that, for lumbar fusion patients, surgery seems to be a last resort. Professionals should fulfill the patients need for information and focus on managing realistic expectations while respecting the distress and strain the illness process has on a patient, thereby potentially increasing patient satisfaction and enhancing postoperative recovery.

Keywords: Coping; Emotion regulation; Interviews; Lumbar fusion surgery; Patient experiences; Qualitative research.

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Interviews as Topic
  • Low Back Pain / nursing
  • Low Back Pain / surgery*
  • Lumbar Vertebrae* / surgery
  • Male
  • Middle Aged
  • Orthopedic Nursing
  • Patient Satisfaction*
  • Perioperative Period
  • Spinal Fusion / psychology*