What is important in Pain Education? The experience of patients with chronic pain and healthcare professionals; A Qualitative Study

Abstract

Rationale: Even though pain education according to the sensitization model is increasingly used and studied, the experiences of patients about pain education are not known. Pain education evolves around the patient and changing his perceptions. Especially with this it is important to know what they experience, in order to improve insight in the pain education. As well as the quality. Question: What are the factors that influence the experience of pain education from the perspective of patients with chronic pain and healthcare professionals? Design: A generic qualitative inquiry according to Grounded Theory was used. Respondents: Patients with chronic pain receiving pain education and healthcare professionals who provide pain education at a transdisciplinary treatment center, Transcare. Data collection and analysis: Fifteen individual interview data were collected. Prior two test interviews were conducted, to test the previously made interview guide. All interviews were conducted according the river model with open questions. Two member checks were held after initial axial coding. A focus group with 6 healthcare professionals took place after the initial theory development. All interviews were transcribed verbatim. Analysis was done according to Grounded Theory and the QUAGOL in an iterative process. Results: Four interacting concepts emerged in a theoretical model. The first was ‘Basics’, and involved the primary needs in order to give pain education to patients. This contained the ‘Intake’ as well as ‘Interpersonal aspects’. The second concept, ‘Comprehensibility’ contained an ‘Understandable Explanation’. As well as the ‘Interaction of the Physiotherapist and Psychologist’, improving the explanation. These concepts influence the third concept, the possible ‘Outcomes’ of pain education. With the themes; ‘Awareness’, ‘Finding Peace of Mind’ and ‘Fewer Complaints’. ‘Scepticism’, the fourth concept, shows apparent doubt towards the diagnosis and pain education. Some respondents rejected sensitization completely. And there was some scepticism due to the way pain education was presented to them. This can have a negative impact on the third concept. Conclusion: This study is the first to provide insight in de underlying factors contributing to the experience of patients with chronic pain with pain education. The complex and interrelated concepts reveal the importance of; a good relationship between the patient and caregiver, taking time, listening, providing a clear explanation and the possible outcomes when this is provided. With regard to generalizability the results of this study can be used to facilitate healthcare professionals in providing pain education.