‘There's No Improvement. I'm Still Bedridden’: Recovery After Hospital Admission for Low Back Pain and Alignment With Patient Expectations

BACKGROUND: Patients with non-serious low back pain (LBP) may present to hospital emergency departments expecting high-value care when community healthcare options are perceived as inaccessible or ineffective. OBJECTIVES: This study explored the experiences and expectations of patients following a LBP-related admission to provide insight into their recoveries and ongoing care needs. DESIGN: Qualitative descriptive methodology using semi-structured interviews. METHODS: Patients admitted with non-serious LBP at a large Australian tertiary public hospital meeting specific inclusion/exclusion criteria and able to participate in semi-structured interviews were pragmatically identified, recruited and consented to participate. Interviews were conducted via telephone with patients in their homes at two and 6 weeks following hospital discharge. Thematic analysis generated codes and themes from interview transcripts. RESULTS: Sixteen patients consented to participate. The cohort had an average age of 52 years (SD = 17) and an average hospital length of stay of 13 days (SD = 10.8, range = 2-31). Two overarching themes were identified. The first described patients' unresolved care needs during an uncertain path to recovery due to persistent pain, failure to experience improvements, and the need for ongoing treatments despite having been admitted to hospital. The second described the heavy burden of pain on physical function and mental health following hospital discharge. CONCLUSIONS: Patients remained negatively impacted and uncertain about their recoveries due to unmet care needs following hospital admission for LBP. Managing expectations of care whilst providing multidisciplinary supports on discharge from hospital may help guide patients' journeys to recovery.