Exploration of How Uncertainty Tolerance, Emotion Regulation, and Hope Are Linked and Influenced in People with Chronic Low Back Pain: A Worked Example of a Social Constructivist Meta-Ethnography Study

Objective: Chronic low back pain (CLBP) is a significant global concern. Its prevalence is increasing, and current management strategies demonstrate, at best, moderate effectiveness. The purpose of this study was to explore the concept of uncertainty tolerance and how it affects an individual’s ability to hope, as well as how both of these factors influence emotion regulation. These concepts are extremely prevalent for patients and clinicians during CLBP consultations. Methods: A social constructivist meta-ethnographic study is a highly interpretative type of qualitative review that generates new theory, enabling valuable insights into this unique area of pain management. A framework was followed; its iterative analytical process involves multiple search strategies in accordance with PRISMA checklists, exploring how studies relate, generating ideas and ultimately developing a substantive theory. Results: This review represents the first worked example of a theory generating review process. One model was created (see Figure 4) that focuses on how an individual with CLBP regulates their emotions, which also considers factors that influence and result from the process. The outcome of the model produced either adaptive or maladaptive emotional regulation strategies (ERS). Conclusions: Tolerance of uncertainty and ability to hope are key concepts that influence emotion regulation and play a vital role in the physical and psychological well-being of people with CLBP. Research is required to explore how the model can be operationalised in clinical practice.