Abstract：
Benefits from low back pain (LBP) treatments seem to be related to patients changing their pain cognitions and developing an increased sense of control. Still, little is known about how these changes occur. The objective of this study was to gain insights into possible shifts in the understanding of LBP and the sense of being able to manage pain among patients participating in a LBP self-management intervention.
Using a qualitative study and a content analytic framework, we investigated the experiences of patients with LBP who participated in \'GLA:D® Back\', a group-based structured patient education and exercise program. Data were generated through qualitative semi-structured interviews conducted between January 2019 and October 2019. Interviews focused on experiences with pain and were analysed using a thematic analytical approach. The Common Sense Model and self-efficacy theory formed the theoretical framework for the interpretations. Participants were sampled to represent people who were either dissatisfied or satisfied with their participation in GLA:D® Back. Fifteen participants aged 26-62, eight women and seven men, were interviewed from February to April 2020.
Four main themes, corresponding to the characterisation of four patient groups, were identified: \'Feeling miscast, \'Maintaining reservations\', \'Struggling with habits\' and \'Handling it\'. The participants within each group differed in how they understood, managed, and communicated about their LBP. Some retained the perception of LBP as a threatening disease, some expressed a changed understanding that did not translate into new behaviors, while others had changed their understanding of pain and their reaction to pain.
The same intervention was experienced very differently by different people dependent on how messages and communication resonated with the individual patient\'s experiences and prior understanding of LBP. Awareness of the ways that individuals\' understanding of LBP interact with behaviour and physical activities appear central for providing adaptive professional support and meeting the needs of individual patients.
Using a qualitative study and a content analytic framework, we investigated the experiences of patients with LBP who participated in \'GLA:D® Back\', a group-based structured patient education and exercise program. Data were generated through qualitative semi-structured interviews conducted between January 2019 and October 2019. Interviews focused on experiences with pain and were analysed using a thematic analytical approach. The Common Sense Model and self-efficacy theory formed the theoretical framework for the interpretations. Participants were sampled to represent people who were either dissatisfied or satisfied with their participation in GLA:D® Back. Fifteen participants aged 26-62, eight women and seven men, were interviewed from February to April 2020.
Four main themes, corresponding to the characterisation of four patient groups, were identified: \'Feeling miscast, \'Maintaining reservations\', \'Struggling with habits\' and \'Handling it\'. The participants within each group differed in how they understood, managed, and communicated about their LBP. Some retained the perception of LBP as a threatening disease, some expressed a changed understanding that did not translate into new behaviors, while others had changed their understanding of pain and their reaction to pain.
The same intervention was experienced very differently by different people dependent on how messages and communication resonated with the individual patient\'s experiences and prior understanding of LBP. Awareness of the ways that individuals\' understanding of LBP interact with behaviour and physical activities appear central for providing adaptive professional support and meeting the needs of individual patients.
摘要：
下腰痛（LBP）治疗的益处似乎与患者改变疼痛认知并增强控制感有关。尽管如此，人们对这些变化是如何发生的知之甚少。这项研究的目的是了解参与LBP自我管理干预的患者对LBP的理解可能发生的变化以及能够管理疼痛的感觉。
使用定性研究和内容分析框架，我们调查了参加“GLA：D®Back”的LBP患者的经历，以小组为基础的结构化患者教育和锻炼计划。数据是通过2019年1月至2019年10月进行的定性半结构化访谈生成的。访谈侧重于疼痛经历，并使用主题分析方法进行分析。常识模型和自我效能理论构成了解释的理论框架。对参与者进行抽样，以代表对参与GLA：D®Back不满意或满意的人。15名26-62岁的参与者，8名女性和7名男性，于2020年2月至4月接受采访。
四大主题,对应于四个患者组的特征，被识别：\'感觉错投，\'维护保留\',\'与习惯斗争\'和\'处理它\'。每个小组中的参与者在他们理解的方式上有所不同，管理，并传达了他们的LBP。有些人认为LBP是一种威胁性疾病，一些人表达了改变的理解，没有转化为新的行为，而其他人则改变了他们对疼痛的理解和对疼痛的反应。
不同的人对相同的干预经历非常不同，这取决于信息和沟通如何与个体患者的经历和对LBP的先前理解产生共鸣。意识到个体对LBP的理解与行为和身体活动相互作用的方式对于提供适应性专业支持和满足个体患者的需求至关重要。
使用定性研究和内容分析框架，我们调查了参加“GLA：D®Back”的LBP患者的经历，以小组为基础的结构化患者教育和锻炼计划。数据是通过2019年1月至2019年10月进行的定性半结构化访谈生成的。访谈侧重于疼痛经历，并使用主题分析方法进行分析。常识模型和自我效能理论构成了解释的理论框架。对参与者进行抽样，以代表对参与GLA：D®Back不满意或满意的人。15名26-62岁的参与者，8名女性和7名男性，于2020年2月至4月接受采访。
四大主题,对应于四个患者组的特征，被识别：\'感觉错投，\'维护保留\',\'与习惯斗争\'和\'处理它\'。每个小组中的参与者在他们理解的方式上有所不同，管理，并传达了他们的LBP。有些人认为LBP是一种威胁性疾病，一些人表达了改变的理解，没有转化为新的行为，而其他人则改变了他们对疼痛的理解和对疼痛的反应。
不同的人对相同的干预经历非常不同，这取决于信息和沟通如何与个体患者的经历和对LBP的先前理解产生共鸣。意识到个体对LBP的理解与行为和身体活动相互作用的方式对于提供适应性专业支持和满足个体患者的需求至关重要。
