Background & Aims
There is an elevated risk of low back pain (LBP) for people who drive occupationally, such as bus drivers, and for people who continue manual material handling for a prolonged period of time, such as freight couriers [1]. Many previous studies have promoted a biopsychosocial caring model for LBP [2]. However, to provide a whole health care, spiritual health should be incorporated. Spirituality discussed about how one relates oneself with a higher source of power and surroundings [3]. In contrast to many previous studies that were completed with questionnaires and surveys, the present study is interested in investigating an in-depth qualitative narrative of patient’s experience in pain and spiritual health. The cause of LBP can be heterogeneous. The present study focuses on individuals whose occupation is the direct cause of their LBP, but these people had to continue that work to make a living. These individuals are the freight couriers and bus drivers.
Methods
This study was approved by the internal review board of Changhua Christian Hospital. Questions for the semistructural interview were preplanned by the researchers. The questions asked about the history of pain, the methods that have been adopted to manage pain, interpersonal relationships before and after pain, how the participant interprets his/her pain experience, and religion. All of the participants were interviewed by the same interviewer. Additionally, the same person sat at the corner of the room to take notes of nonverbal expressions. All interviews were recorded for later analysis. The transcripts were imported into NVivo for qualitative analysis. Thematic analysis was used to analyze the transcripts.
Results
Five patients with chronic LBP participated in the study. Among them, four were male and one was female. The participants aged between 27 and 44?with a mean of 36.6 (SD 6.65). Two of the participant had a full time job, the rest had a part time job. One participant had surgery for back pain. Two among them used morphine as the main pain control method. Three participant had the religion Tao, and the other two described themselves as no religion belief. Thematic analysis revealed 2 themes regarding spirituality: “1.religion practice guided medical decisions”, and “2.connection and disconnection after pain”. Three participant mentioned about their experiences in asking the higher power for guidance in making medical decisions such as whether or not to undergo surgery, or which doctors to go to. About theme2, two participants shifted their attitudes toward religion, and two participants had a tighter connection with their religion after pain. One remained no religion.
Conclusions
Similar to precious study, most participants engaged in some forms of spiritual practices to cope with pain [4]. Through this study, it became obvious that individuals exhibited spiritual needs in dealing with pain. Handing over to God the power to make major medical decision does not mean giving up free will. Instead, individuals can experience a sense of reassurance for something they feel very uncertain of. On the other hand, this result also showed that the connection between individual and religion can change over the course of pain. This might reflect a process of bargaining between pain and faith. A lesson from the current qualitative interview is that, in the field of clinical care, notice that sometimes a patient’s wish does not always reflect a decision deducted from pure logical reasoning. It can be a complex computation that involves biological, social, psychological and spiritual factors.
References
1.Okunribido, O. O., Magnusson, M., Pope, M. (2006). Delivery drivers and low-back pain: A study of the exposures to posture demands, manual materials handling and whole-body vibration. International Journal of Industrial Ergonomics, 36 (3), 265-273.
2.Igwesi-Chidobe, C. N., Coker, B., Onwasigwe, C. N., Sorinola, I. O., & Godfrey, E. L. (2017). Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: a population-based cross-sectional study. BMJ global health, 2(3), e000284.
3.Courtney, R. E., Schadegg, M. J., Bolton, R., Smith, S., Harden, S. M. (2024). Using a Whole Health Approach to Build Biopsychosocial-Spiritual Personal Health Plans for Veterans with Chronic Pain. Pain Management Nursing, 25 (1), 69-74.
4.Taylor LEV, Stotts NA, Humphreys J, Treadwell MJ, Miaskowski C. A biopsychosocial-spiritual model of chronic pain in adults with sickle cell disease. Pain Manag Nurs. 2013;14(4):287-301.