Affiliations: Elective Orthopaedic Department, Bolton One, Bolton, UK | Independent Research Consultant | Executive Dean and Pro Vice-Chancellor of the School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK | School of Sport, Tourism and Outdoors, University of Central Lancashire, Preston, UK
Note:  Corresponding author: Dr. Sue Greenhalgh, Elective Orthopaedics, Bolton NHS Foundation Trust, Bolton, UK. Tel.: +44 01204462757/07881970020; E-mail: [email protected]
Abstract: PURPOSE: The aim of this study was to identify how Cauda Equina Syndrome (CES) symptoms may be more effectively identified by patients along with their experiences with clinicians. Patient's symptoms and understandings of their condition were explored, including issues associated with bladder, bowel and sexual function. METHOD: An interpretive research paradigm using a narrative approach was adopted utilising qualitative one-to-one semi-structured interviews. Narrative research is a useful way to explore patients' perceptions of and the meanings attached to CES symptoms. The clinical setting was within an NHS Foundation Trust in an industrial town in the Northwest of England. Participants were recruited from the population of patients who, in the preceding 18 months had attended the Orthopaedic service for care related to CES. New cases presenting during the data collection period were also eligible for inclusion. Ten patients consented, 7 females and 3 males, average age 58.5 years (range 33–72). All interview data was transcribed and subjected to narrative analysis. The narrative analysis explored perceptions of and the meanings associated with the personal and emotional aspects of the participant's pain and symptoms, along with how these aspects of the participants experiences were relayed to the clinician or affected their interaction with clinicians. RESULTS: Narrative analysis identified two key issues to be essential in facilitating timely diagnosis of CES a) clinician's knowledge of signs and symptoms and an awareness of these by patients b) communication about these signs and symptoms using a language understandable to both patients and clinicians.