Patient journey following lumbar spinal fusion surgery (FuJourn): A multicentre exploration of the immediate post-operative period using qualitative patient diaries

• DOI: 10.1371/journal.pone.0241931
• Publication Date: 2020-12-01T16:09:17Z
• Authors: Alison Rushton; Feroz Jadhakhan; Annabel Masson; Victoria Athey; J. Bart Staal; Martin L. Verra; Andrew Emms; Michael Reddington; Ashley Cole; Paul C. Willems; Lorin Benneker; Nicola R. Heneghan; Andrew Soundy
• Keywords: Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences; degenerative-spondylolisthesis; Male; Science; 610 Medicine & health; low-back-pain; STENOSIS; burden; 03 medical and health sciences; 0302 clinical medicine; MANAGEMENT; Humans; Postoperative Period; DEGENERATIVE-SPONDYLOLISTHESIS; Leg; Lumbar Vertebrae; Q; stenosis; R; Lumbosacral Region; Neurodegenerative Diseases; Middle Aged; 16. Peace & justice; stroke; 3. Good health; Spinal Fusion; Treatment Outcome; Back Pain; Medicine; Female; BURDEN; management; STROKE; LOW-BACK-PAIN; Research Article

The aim of this study was to capture and understand the immediate recovery journey patients following lumbar spinal fusion surgery explore interacting constructs that shape their journey. A qualitative using Interpretive Phenomenological Analysis (IPA) approach. purposive sample 43 adult (≥16 years) undergoing ≤4 level instrumented for back and/or leg pain degenerative cause, were recruited pre-surgery from 4 UK centres. Patients completed a weekly diary expressed in own words first weeks life as lived. Diary content based on previous research findings recorded progress, recovery, motivation, symptoms, medications, healthcare appointments, rehabilitation, positive/negative thoughts, significant moments; comparing week. To maximise completion data quality, diaries could be paper form, word document, online survey or audio recording. Strategies enhance adherence included prompt. framework analysis individual then across participants (deductive inductive components) captured emergent themes. Trustworthiness enhanced by strategies including reflexivity, attention negative cases use critical co-investigators. Twenty-eight (15 female; n = 18 (64.3%) aged 45–64) contributed (12 withdrew post-surgery, 3 did not follow through with surgery). Adherence 89.8%. Participants provided diverse vivid descriptions experiences. Three distinct trajectories identified: meaningful (engagement physical functional activities return functionality/mobility); progressive (small but improvement ability increasing confidence); disruptive (limited purpose recovery). Important shaped participants’ experience self-efficacy. This is account patients’ perspectives. Recognition patient’s trajectory may inform patient-centred follow-up rehabilitation improve patient outcomes.