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Acknowledging the patient with back pain: A systematic review based on thematic synthesis'

Janne Brammer Damsgaard, Lene Bastrup Jorgensen, Annelise Norlyk, James Thomas, Regner Birkelund


Rationale and aims: Research shows that back patients’ illness experiences affect their interaction with the healthcare system. It is important to examine the exact nature of these experiences in order to shed valuable light on how back patients perceive their illness and hospitalisation. The aim of this literature review is to gain a better understanding of back patients’ illness experiences and to identify, systematise and integrate the findings of different qualitative studies that may elucidate barriers and the consequences or focal points in connection with care and treatment.

Methods: The methodology for this literature review is based on the thematic synthesis used by James Thomas and Angela Harden. The literature review also draws on the sociological theories and arguments of Ulla Harriet Jensen and Trine Dalsgaard in which health professionals biological perception of the individual dominates the healthcare system and translates into a certain way of perceiving and explaining illnesses and symptoms.   

Results: The thematic analysis shows that it is through experiences and memories that we create our identity and consciousness. Ignoring the illness experiences can therefore be seen as disregarding, the patient as a human being. With this in mind, it is easier to understand why back patients often feel marginalised and mistrusted in their interactions with the healthcare system. Respectfully including the patients’ experiences is fundamentally about acknowledging the back patient as a human being.

Conclusions: A synthesis of the included studies demonstrates the need for healthcare professionals to pay attention to back patients’ narratives in order to acknowledge them as human beings. This acknowledgement involves an ethical dimension and a sense of responsibility, manifested as respectful inclusion of the patient’s experiences. The body can never be understood merely as a biological entity and therefore illness is far more than having symptoms, diagnoses and treatment. The synthesis thus proposes an acknowledgment of this and a more holistic approach.

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