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.