Abstract

Many veterans suffer chronic pain, which may be exacerbated by military shaped attitudes to health. There is a paucity of research that explores veterans’ experiences of developing coping strategies to manage chronic pain. This study employed a qualitative, Grounded Theory (GT) approach with seven participants. The participant involvement was via in-depth semi-structured interviews (male-6, female-1, mean age-46.0yrs, mean service-17.71yrs, mean pain-9.14yrs, pain sites-7, multiple pain sites-71%). The analysis led to the development of a theory of veterans’ relationship with chronic pain (CP). The analysis produced five theoretical categories that informed the Grounded Theory of veterans’ pain management strategies: “Oscillating Emotional Responses,“ “Activation of Coping Strategies.” “Ambivalent Help-Seeking Patterns,” and “Knowledge as Power.” The participants’ familiarity with military conditioning enabled them to feel in control of the uncontrollable and employ practical, pragmatic approaches to managing pain. Civilian status was associated with feeling somewhat vulnerable and less in control. The findings of this study are supported by previous studies, although this study challenges the view that veterans are poor help-seekers. Whilst veterans may have experiences that exacerbate pain unnecessarily, other experiences may reduce pain. Therefore, it is essential to employ a veteran-civilian approach to care management to understand the impact that collective life experience has on pain management. A veteran-civilian approach could be incorporated into personalized future pain management programs. By providing a rich sample of data, this research provides a basis for future studies to expand upon the current theory of veterans’ relationship with CP.

Highlights

  • Lazarus & Folkman (1984) defined coping as adaptively changing behavioral and cognitive efforts to manage internal and external subjective stressors

  • Osteoarthritis can be high for women and African Americans (Stanishewski & Zimmermann, 2015), indicating genetic factors may influence the severity of arthritis in veterans

  • A possible reason that veterans may turn to charities for pain support is that pain clinics run through the National Health Service (NHS) may be insufficient for their unique needs

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Summary

Introduction

Lazarus & Folkman (1984) defined coping as adaptively changing behavioral and cognitive efforts to manage internal and external subjective stressors. Some health-related data is available; soldiers are at an increased risk of suffering injuries affecting their back and legs, especially the lower legs and feet This is due to training on hard surfaces, marching, carrying heavy equipment, and assuming specific positions (e.g. the firing position) (Ministry of Defence, 2017). Many veterans are anti-medication for fear of addiction (Amirni, 2018) Those clinics that offer group management sessions, where therapies such as Cognitive Behavioral Therapy (CBT) are weaved into pain management, may not factor that a group is a diverse group of different attendees (BPS, 2014). Those running the group sessions may not consider that veterans have differing, yet quite specific, beliefs around pain management. The current study will explore these beliefs in significant detail utilizing a qualitative approach

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