Interestingly, social function was the most frequently selected domain with pain intensity, although participants did not consider social health as an important area as physical health, which was obviously supported by the results of the open-ended question and PROMIS cards parts of the interview. Social function was merged from two PROMIS domains; “ability to participate in social roles and activities” and “satisfaction with social roles and activities”. These two domains were combined because the participants had difficulty differentiating between them and therefore they only selected one of them during the interview. A systematic review showed that the social component of life was important for individuals with LBP 55. In addition, WHO reported that LBP affects the work performance among individuals with LBP and it considered a leading cause of work absence and loss 53.
The least frequent domains among those that were perceived as important by patients were anger and pain interference. Anger domain referred to mental health; this domain was
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Other than the anger domain, there were no frequent domains that were selected by patients either in the open-ended question or PROMIS cards selection. In the open-ended question, anxiety and depression were stated only twice, while during the cards selection these two domains were selected by 6 and 4 participants, respectively. However, a systematic review on the LBP impact showed that anxiety and depression were frequently reported by individuals with LBP 55. The findings of this study explained why patients did not consider depression and anxiety as important domains; these two domains were frequently stated as consequences of pain, fatigue, and restriction in physical and social activities. Therefore, patients might think that if the latter domains (i.e. pain, fatigue, and restriction in activities) were addressed, the anxiety and depression would be