{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T16:42:43Z","timestamp":1774543363327,"version":"3.50.1"},"reference-count":94,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000855","name":"University of Birmingham","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000855","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>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\u2019s 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\u2014a highly interpretative type of qualitative review\u2014was 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.<\/jats:p>","DOI":"10.3390\/bs15101399","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:29:38Z","timestamp":1760599778000},"page":"1399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0684-7032","authenticated-orcid":false,"given":"Justine","family":"McMillan","sequence":"first","affiliation":[{"name":"School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Raleigh Heights, Barnstaple, Devon EX31 4JB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5118-5872","authenticated-orcid":false,"given":"Andrew","family":"Soundy","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.29252\/nirp.cjns.4.12.18","article-title":"Effectiveness of mindfulness-based cognitive therapy on hope and pain beliefs of patients with chronic low back pain","volume":"4","author":"Abdolghaderi","year":"2018","journal-title":"Caspian Journal of Neurol Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1177\/10497323211014858","article-title":"The experiences of people living with chronic pain during a pandemic: \u201cCrumbling dreams with uncertain futures\u201d","volume":"31","author":"Amja","year":"2021","journal-title":"Qualitative Health Research"},{"key":"ref_3","first-page":"71","article-title":"Self-efficacy","volume":"Vol. 4","author":"Ramachaudran","year":"1994","journal-title":"Encyclopedia of human behavior"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"640","DOI":"10.2340\/16501977-0104","article-title":"Recurrent low back pain: Relapse from a patient perspective","volume":"39","author":"Benjaminsson","year":"2007","journal-title":"Journal of Rehabilitation Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bottesi, G., Noventa, S., Freeston, M. 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