# 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

## TL;DR

This study explores how tolerance for uncertainty and hope influence emotion regulation in people with chronic low back pain, offering a new model to understand their emotional and psychological well-being.

## Contribution

The paper presents the first worked example of a theory-generating social constructivist meta-ethnographic study on chronic low back pain.

## Key findings

- A model was developed to illustrate how uncertainty tolerance and hope influence emotion regulation in CLBP patients.
- The study identifies pathways leading to adaptive or maladaptive emotional regulation strategies.
- Tolerance of uncertainty and hope are key factors affecting both physical and psychological outcomes in CLBP.

## Abstract

Chronic low back pain (CLBP) is a significant global concern. Its prevalence continues to rise, 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 highly relevant for both patients and clinicians during CLBP consultations. A social constructivist meta-ethnographic study—a highly interpretative type of qualitative review—was conducted to generate new theory and provide 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 guidelines. The analysis explored relationships among studies, generated conceptual ideas, and ultimately developed a substantive theory. This review represents the first worked example of a theory generating review process. One model is created to illustrate how individuals with CLBP regulate their emotions; it also considers both the influencing factors and the resulting outcomes of this process. The model identifies pathways leading to either adaptive or maladaptive emotional regulation strategies. 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. Further research is required to explore how the model can be operationalised in clinical practice.