鈥淭here's More to This Pain Than Just Pain鈥? How Patients' Understanding of Pain Evolved During a Randomized Controlled Trial for Chronic Pain
- 作者：Marianne S. Matthias&lowast ; ; &dagger ; ; &Dagger ; ; mmatthia@iupui.edu ; Edward J. Miech&lowast ; ; &dagger ; ; § ; ; Laura J. Myers&lowast ; ; ¶ ; ; Christy Sargent&lowast ; ; Matthew J. Bair&lowast ; ; &dagger ; ; ¶ ;
- 关键词：Chronic pain ; self-management ; qualitative research ; veterans ; randomized controlled trial
- 刊名：The Journal of Pain
- 出版年：2012
- 期刊代码：332_15265900
- 类别：med
- 出版时间：June, 2012
- 卷：13
- 期：6
- 页码：571-578
- 文件大小：263 K
摘要
Chronic pain is prevalent, is costly, and exerts an emotional toll on patients and providers. Little is known about chronic pain in veterans of the recent military conflicts in Afghanistan and Iraq (OEF/OIF/OND [Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn] veterans). This study's objective was to ascertain veterans' perceptions of a multicomponent intervention tested in a randomized controlled trial for OEF/OIF/OND veterans with chronic musculoskeletal pain (ESCAPE: Evaluation of Stepped Care for Chronic Pain). Qualitative interviews were conducted with patients in the intervention arm of ESCAPE. Questions related to veterans' experiences with trial components, overall perceptions of the intervention, strengths, and suggestions for improvement. Twenty-six veterans (21%of total intervention patients) participated. Patients were purposefully sampled to include treatment responders (defined as 鈮?0%reduction in pain-related disability or pain severity) and non-responders. Non-completers (completed <50%of the trial) were also sampled. Qualitative analysis was guided by grounded theory, using constant comparative methodology. Both responders and non-responders spoke about their evolving understanding of their pain experience during the trial, and how this new understanding helped them to manage their pain more effectively. This evolution is reported under 2 themes: 1) learning to recognize physical and psychosocial factors related to pain; and 2) learning to manage pain through actions and thoughts.
Perspective
Responders and non-responders both described making connections between their pain and other factors in their lives, and how these connections positively influenced how they managed their pain. Traditional quantitative measures of response to pain interventions may not capture the full benefits that patients report experiencing.