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. 2011 Sep 20;13(5):R152. doi: 10.1186/ar3468

Table 2.

Clusters, subclusters and representative statements

Clusters and subclusters Representative statements
Psychosocial
 Loss
  Loss of expectations Limitations on fulfillment of goals in life
  Loss of enjoyment Loss of enjoyment in life
  Loss of self-confidence Low self-esteem, especially from loss of roles
Feel helpless when people stop you doing things
 Negative affect Irritation, anger and frustration
 Worry and negative beliefs about the future Worry about the future
Fear that severe back pain will occur again
 Global malaise
  Secondary health effects Difficult to address other health issues
May lead to weight gain
  Effort of life/daily grind Tiredness
Makes you feel old
Loss of motivation in life
  Executive challenge Always having to think about what you can and cannot do
 Domestic psychosocial challenges
  Loss of family and intimate involvement Left out of family activities
Difficulty caring for others
  Loss of independence Need to ask for help to do things
 Negative reactionsa
  Challenged integrity/feeling believed May be seen as a malingerer
Wrongly considered lazy by others
  Self-worth degraded by how you feel others see you Always trying to hide pain from family so they do not worry
Feel like a burden on workmates
  Negative/discriminatory actions by others Bullied by others
May lose friends
Physical
 Functioning outside the home Makes it hard to travel
Leisure activities are limited
 Specific physical limitations Daily living is hard including basic self-care
Difficulty lifting things
Hard to sit
 General physical impact More and more physically unfit
Fall easily
Treatment
 Treatment services
  Frustration of treatment (quality) Waste time and money on dubious treatments and practitioners
Unnecessary surgery and the problems this causes
  Frustration with healthcare providers Doctors not understanding there is anything wrong with you
Back pain can make you distrust the medical profession
 Condition burden
  Impact on othersb Need help from carers
  Medication Dependent on more and more medication
Side-effects
  Financial costs/expenses Costs of treatment and equipment (necessary and unnecessary)
Employment
 Challenges when out of work Difficult to get back to paid employment
Reduced employment options, now and for the future
 Challenges when workingc Many limitations on what tasks can be done
 Effects of employment challenges Difficult to get health insurance
Reduced income resulting in poverty

aSee also Employment. bSee also Challenges when working, Psychosocial. cSee also Impact on others.