Skip to main content

Table 2 Key qualitative themes

From: Measuring the impact of chronic low back pain on everyday functioning: content validity of the Roland Morris disability questionnaire


Example quote

Number of participants


Walking more slowly

“No. I walk, [I just] I don’t walk as fast” P01–006


Can only walk short distances

“Walking, I can’t walk for long periods of time even though I try. I … that’s what one of my exercises. I try to push myself” P01–002


Using a handrail on stairs/steps

“So I’m just real careful when I walk, and I grab handrails when I go down stairs.” P02–007


Go upstairs more slowly

“I have a hard time going up and down steps … I have to hold the railing and I have to do one step up. One step up. One step [at a time moving slowly]-” P03–004

Sitting and standing*

Unable to sit or stand for long periods of time

“Yeah, I can’t stand ... I mean, I can’t stand too much, I can’t sit down too much.” P01–007

Sitting 23/23; 8/23 also discussed problems with standing

Changing position to get comfortable

“Sitting for a long time and standing up, uh, takes a while to, you know, get to where I can, I’m comfortable moving forward I need to get up … Get the, you know, the soreness out. Because if I, if I sit for a long period, it’s really difficult” P01–001

Holding something to get in/out of a chair

“at certain times, when I’m either getting up out of a chair, or sitting in a chair, and that it feels like my back has gone out, then I have to really grab on to something.” P03–007

Difficulty getting out of a chair

“I mean sometimes it’s just getting up out of a chair, or sometimes it’s sitting in a chair [which cause pain], you know what I mean?” P03–007

Sitting down more

“And sometimes if it’s, you know, a 7 or 8 [pain] day, then I’ll sit in the recliner with the heating pad.” P02–003

Bending and kneeling

Pain while bending

“it’s just pain like on my lower back. Like, say if I bend over” P01–003


Pain while kneeling

“Um, probably like taking stuff out of the washer, to bend down to put it into the dryer … or clean the litter box, when you’re, you know, when you’re ... kneeling and scooping [are more difficult because of the CLBP]” P02–003

Avoiding bending/kneeling or using assistance

“[my wife] Ties my shoes for me. Uh, like, uh, bending over is, uh, hard” P01–005


Pain while lifting

Lifting. I, I occasionally do land-scaping at our house and lifting bags of, uh, mulch, bags of dirt, um, doing those a lot definitely brings on the back pain” P02–004


Avoiding lifting

“Uh, I’ll be honest with you. I don’t do nothing heavy. Anything that’s probably 50 pounds or more, I really stay away from that kind of stuff” P01–005

Lying down

Lying down was not spontaneously reported in the concept elicitation section of the interviews, it was highlighted as important and relevant to 23/23 participants during the cognitive debriefing of the RMDQ, and as such was pulled into the conceptual model.

Chores/ housework

Avoiding/not doing as many jobs around the home

“Sometimes, just when I have severe pain or when I feel an onset coming on......I feel like I can’t function correctly. So, I sometimes just decide not walk my dog, clean the house or wash my car.” P01–008


Being slower/not getting as much done

“You know, so instead of knocking half my list on a weekend I might, just get one project done. Just take my time with it”. P02–001

Getting other people to do jobs

“I hire young men with strong backs to do jobs around the home [as I can’t do it now].” P02–007


Trouble putting on socks, shoes and trousers

“I’ve not been able to put on my socks and shoes and struggle mightily with my pants” P02–004


Needing help to get dressed

“my girlfriend puts my socks on for me and my shoes … So she [girlfriend] does the pants, you know” P01–005

Getting dressed more slowly

“You give yourself a little bit more time to get dressed once in a while or a little bit more time to go somewhere” P02–008


Difficulties with washing

“Um, well, you know, in the shower, again, I’m very conscious about all movements, um luckily we have grab bars and things in there. I utilize those. Um, minimize twisting, uh bending, you know all that sort of thing” P02–001



Getting in and out of cars

“[getting] Out of, out of a car, certain cars … The lower the chair or the, whatever you’re sitting on … the harder” P02–008


Remaining in the same position long periods of time

“once that happens [Pain from CLBP], I am not able to go out to work. Um, just because I, I’ll normally be a long time of period in the car [and I can’t sit for that period of time].” P01–008


Not able to work or do same job/taking a break at work

“Um, to the point at work where I actually have to stop working for that little bit of time, to try and ease the pain in my back” P03–007


“Uh-huh (affirmative), because now, yeah, not working because I always have a pain, so I do the best I can” P01–007

Relationships and socializing

Missing events/Staying at home

“I mean, family picnics, … we missed Christmas Eve with the family. [we have missed] All kinds of family functions over the years. You know, we’ve been married for, uh, 21 years so there’s been lots of things over the years [we have missed because of the CLBP].” P02–004


Relationships with children and family

“my kids I could never do anything with them. I couldn’t play football, or baseball. I tried to coach little league with my son and I couldn’t do it. It was too much pain. I tried to play softball myself and I couldn’t do it. I had to, I had to quit because I couldn’t run”. P03–006

Sexual activities

“Um, I haven’t had sex for over, maybe 15 years. [because of my CLBP]” P03–004

Support system

”I have very strong support system, very strong, um, family ties” P01–002


Moody, irritable and short tempered

“Oh, yeah. I think, uh, I feel like I’m more agitated easily. I have mood swings, constantly” P01–008


Depression and anxiety

“Um, I, I get depressed because of, thinking about things that I used to do, that I can’t do, and there’s a whole lot of other things” P03–004


Hard to fall asleep

“Oh, yes. Um, I find it hard to fall asleep sometime” P01–008


Waking up

“It’s, um, say, say when I’m lying in bed sleeping at night … I, I wake up and, and, and I got to ... and I can’t move. I got to get up. I’ve got to sit up and I’ve got to sit there for a minute because it hurts so bad” P03–006

Can’t get comfortable

“like I’m tossing and turning. I try to do the lying on the side, put the pillow between my legs for my spine and, uh, I tried the pillows up, raising my feet up. You know, I, I did different things” P01–005


Appetite was not spontaneously reported in the concept elicitation section of the interviews, it was highlighted as important and relevant to 21/23 participants during the cognitive debriefing of the RMDQ, and as such was pulled into the conceptual model.

  1. *Difficulties with standing were only discussed with difficulties with sitting and as such these topics were combined as an example of similar limitations
  2. #Not all participants engaged in paid work