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Table 2 Changes over time in expectations and hopes for improvement: quotations for each type of treatment

From: A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies

Time and therapy Quotation Summary
Nora (Chiropractic participant, Seattle)
Pre-treatment I’m hoping that I’ll feel better. I’m hoping that long term that this will lessen my pain and give me a better quality of life. That’s what I’m hoping for. But I’m not going in with an expectation that this is what’s going to happen. DC-124-1 Modest hopes for less pain and better quality of life; No expectations expressed
2 weeks later I’m not even going to go there [to talk cure] until I have a couple more adjustments. It may and that would be so wonderful. And if it doesn’t, if I -- I can live really happily where I am right at this point. DC-124-2 Substantial improvement in pain but still hesitant to hope for too much; Says she is satisfied with current level of pain
3 months later So my expectations are that as long as I kind of tow the line and do the things that I need to do and be responsible … My expectation is that I will be able to stay out of pain as long as I’ve got my brain and I can move around. DC-124-3 Expectations for sustained improvement with continued maintenance and self-care
John (Acupuncture participant, Seattle)
Pre-Treatment Bottom line is that I want to be relieved of the pain that I have. I would say I don’t have expectations beyond the current pain. In other words I’m not going into this thinking that as a result of the treatment I’m no longer going to have back pain. LAC-123-1 Expectations for relief of current pain; Not expecting to get overall complete cure forever
2 weeks later I was not expecting [diet and other recommendations]. And so it had more to do with lifestyle change and the way that my eating habits… I think [acupuncture has] changed my outlook on how I manage my health. Which ultimately affects my back. LAC-123-2 Surprised by recommendations for self-care, diet changes; Changed outlook on health management
3 months later I just know that this is a weakness in my lower back that I’m probably going to have with me and I just got to be much more aware of it and deal with it and not wait ‘til I can’t walk… [the practitioner] helped me be much more aware of what I need to do to keep this under control and to manage my life and the stress in my life. LAC-123-3 Focus on management of stress and awareness of underlying issues and need for continued maintenance
Sarah (Massage participant, Seattle)
Pre (early)-treatment Oh, I thought it would definitely get better. I was really assuming that I would have, you know, less pain and that maybe it would take a number of treatments, but that eventually it would help alleviate the problem… I was hoping [it would cure]. LMP-137-1 Expectation of less pain; hoping for a cure for pain
2 weeks later Well, I think it will get better. I do have expectations that it will get better, but I also think I have to be a lot more cognizant of the way that I use my body. And not be as, you know, careless. LMP-137-2 Expectation of improvement in pain; increased awareness of need to be more attentive to body
3 months later I think it might be a lifelong treatment, although probably not as frequently once I get on top of it. You know? But I think it’s definitely going to be, maintenance is gonna be just part of the whole scene. LMP-137-3 Shift to seeing maintenance of activities to address back pain as lifelong
Jeanne (Yoga participant, Seattle)
Pre-treatment I think it will give me tools to kind of control it, more tools to enable my body to be aware of some of the different muscles or areas or maybe things I shouldn’t do to it, to help control the pain or also learn different things that maybe can relieve it [so]… it’s not causing the pain. YI-132-1 Expectation of tools to help control or relieve pain (or cause of pain)
2 weeks later I feel that there has to be a lot more that we’re just not doing yet, but I don’t know, I just have to get into that routine and they make it simple enough you can do it at home using things you have at home, so I’m kind of expecting even if I were to only take class for a few months, it would have given me some tools and knowledge to keep doing it at home. YI-132-2 Expecting tools and knowledge to continue at home
3 months later I took it for a while and then I stopped taking it for a while, I had too many things that came up and I … I noticed kind of a big, big backslide difference again. So, … so I’ve kind of found that I kind of have to make it part of my routine if I’m gonna feel comfortable… At least I have some tools now, I can use to help. But I have to be the one using the tools. YI-132-3 Realization that yoga has to be part of routine maintenance; Having tools is only the first step, need to use the tools to experience benefit