Experiences of recovery and rehabilitation from surgery to treat neurogenic claudication. A qualitative study

Purpose: This study aimed to explore the experiences, expectations, attitudes and beliefs about surgery and recovery in people with neurogenic claudication, and their preferences for rehabilitation.

Methods: Semi-structured interviews were conducted with a purposive sample of 16 patients (8 female; mean age 70 years) following surgery for neurogenic claudication. Data were transcribed verbatim, analysed using reflexive thematic analysis and interpreted using the five constructs of the Integrative Model of Expectations: treatment, timeline, behaviour, outcome, and generalised expectations.

Findings: Three themes were developed: (1) making sense of recovery through a biomedical model of illness; (2) the mismatch between expectation and recovery (subthemes: the unanticipated burden of recovery; hope versus reality: expectations of the ultimate outcome); (3) one size doesn't fit all: the need for tailored rehabilitation. Participants expressed a preference for tailored, supervised rehabilitation commencing 2-6 weeks post-surgery. Some participants preferred one-to-one and some group-based rehabilitation. Some participants thought pre-operative rehabilitation would be beneficial.

Conclusions: Patient's experiences and satisfaction with their care and outcome are heavily influenced by their expectations. Tailored rehabilitation should reframe unrealistic expectations regarding care, recovery, and ultimate outcome; educate patients on the biopsychosocial model of pain; and equip patients with the knowledge and skills to optimise their outcome.IMPLICATIONS FOR REHABILITATIONPeople with neurogenic claudication interpret their condition, symptoms, and recovery from surgery through a mechanistic, biomedical lens.The experience and recovery from surgery for neurogenic claudication can be unexpectedly challenging and burdensome.Healthcare professionals should support patients by helping to set realistic expectations of post-operative care, recovery, and outcome from surgery.People undergoing surgery for neurogenic claudication want rehabilitation, personalised to their individual circumstances and requirements.