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Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-6075-4432
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum Region Jönköping County.
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
2016 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 4, 352-358 p.Article in journal (Refereed) Published
Abstract [en]

Subjects: Fourteen women aged 39-62 years (median 52 years), were included 1.5 to 3 years after ACDF for cervical degenerative disc disease.

Methods: Individual semi-structured interviews were analyzed by qualitative content analysis with an inductive approach.

Results: The women described their experiences of daily life in five different ways; Experiences of recovery; Experiences of symptoms in daily life influence feelings and thoughts; Making daily life work; Importance of social  and occupational networks; Experiences of the influence of healthcare professionals and interventions on daily life.

Conclusion: This interview study provides insight into women’s daily life after ACDF. While improved after surgery, informants also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge on aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after ACDF.

Place, publisher, year, edition, pages
Uppsala, Sweden: Stiftelsen Rehabiliteringsinformation /Foundation for Rehabilitation Information , 2016. Vol. 48, no 4, 352-358 p.
Keyword [en]
Daily life, cervical spine, research interview, content analysis
National Category
Medical and Health Sciences Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-117344DOI: 10.2340/16501977-2076ISI: 000372456100005PubMedID: 26999327OAI: oai:DiVA.org:liu-117344DiVA: diva2:807481
Note

Funding agencies: NSC FoU-fond; County Council of Ostergotland

Available from: 2015-04-23 Created: 2015-04-23 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Clinical and patient-reported outcomes after anterior cervical decompression and fusion surgery: A focus on functioning and daily life
Open this publication in new window or tab >>Clinical and patient-reported outcomes after anterior cervical decompression and fusion surgery: A focus on functioning and daily life
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Anterior cervical decompression and fusion (ACDF), with or without an intervertebral cage to add support to the fused segment, is an established surgical treatment of cervical radiculopathy due to cervical disc disease. High recovery rates and pain reductions after surgery have been reported, with similar results with or without a cage. A few small studies have evaluated neck-related physical function and patient-reported disability with less promising results. No previous studies have evaluated clinical and patientreported measures of functioning or compared the Cloward Procedure with the Cervical Intervertebral Fusion Cage (CIFC) more than 10 year after surgery. No studies have explored the patients’ perspective on surgical outcome Knowledge on long-term functioning may provide a base for improved postoperative care and rehabilitation. Combining the perspectives of clinicians and patients may provide a better understanding of outcome after ACDF surgery than has previously been reported.

The overall aim of the thesis was to evaluate long-term functioning after anterior cervical decompression and fusion surgery due to cervical disc disease, and to provide new insights into patients’ experiences of daily life after surgery.

The more than 10-year patient-reported outcomes of pain, disability and psychosocial factors (n=77), as well as clinical outcomes of neck-related physical function (n=51) were evaluated and compared between the Cloward Procedure and the CIFC. Preoperative and surgery-related factors of importance for a good outcome in neck-related pain and disability at 10-year follow-up were also identified. Fourteen women were interviewed at 1.5 to 3 years after ACDF to explore their experiences of daily life.

There were no differences between the surgical techniques in long-term neck-related pain or patient-reported disability. Secondary outcomes were, with a few exceptions, similar between groups. Neck-related pain decreased after surgery and remained improved from the 2-year to the 10-year follow-up. However, disability ratings remained improved only in the CIFC group. Predictors of a successful outcome in neck-related pain intensity were high preoperative neck-related pain intensity (Odds Ratio 1.06) and nonsmoking (Odds Ratio 3.03). Male gender was the only predictive factor of a successful outcome in neck-related disability (Odds Ratio 4.33). Moderate to severe pain and patient-reported disability were seen in half of the participants at the 10-year follow-up, and neck-related physical impairments were seen in between 18% (cervical flexion) and 82% (neck-muscle endurance) of participants. Daily life was experienced as recovered or improved by women after ACDF surgery. However they were at the same time affected and limited by remaining symptoms. Behaviors and activities were altered to adjust to the symptoms. Social support provided by family, social and occupational networks, and by healthcare professionals were experienced as important in a good daily life.

In conclusion: long-term pain, physical function and patient-reported disability were similar between the two ACDF techniques. High preoperative pain intensity, non-smoking and male gender predicted a good long-term outcome. Individuals after ACDF surgery experienced improvements in pain intensity and a good effect of surgery although they simultaneously reported residual or recurrent disability.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 77 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1443
National Category
Physiotherapy Nursing
Identifiers
urn:nbn:se:liu:diva-117347 (URN)10.3384/diss.diva-117347 (DOI)978-91-7519-134-8 (ISBN)
Public defence
2015-05-22, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
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Available from: 2015-04-23 Created: 2015-04-23 Last updated: 2015-05-06Bibliographically approved

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Hermansen, AnnaPeolsson, AnneliKammerlind, Ann-SofiHjelm, Katarina

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