Abstract
Background and objectives: Limited evidence exists exploring perceptions of which aspects of a pain management program are perceived as valuable and impactful. The aim of this study was to explore patient beliefs about which aspects of a pain management program were valued and/or had perceived impact. Materials and Methods: One-on-one structured interviews were conducted with 11 adults three months after their completion of the Spark Pain Program at Westmead Hospital, Sydney, Australia. Concepts in the transcripts were inductively identified and explored, utilizing thematic analysis to better understand their relevance to the study aim. Results: Four themes emerged: (1) “The program overall was positive, but…”; (2) “I valued my improved knowledge and understanding of pain, but…”; (3) “I valued the stretching/relaxation/pacing/activity monitoring”; and (4) “I valued being part of a supportive and understanding group”. Participants reported that they liked being treated as an individual within the group. A lack of perceived personal relevance of key messages was identified in some participants; it appears that patients in pain programs must determine that changes in knowledge, beliefs, and attitudes are personally relevant in order for the changes to have a significant impact on them. Conclusions: This study provides new insights into aspects of a pain management program that were perceived as valuable and impactful, areas that “missed the mark”, and hypotheses to guide the implementation of service delivery and program redesign.
Highlights
Persistent pain creates an enormous biopsychosocial burden
15.5% of work absence is due to back pain [4], and in terms of financial impacts, a 2018 report estimates that overall annual costs of persistent pain in Australia exceed AU$73 billion (AU$139 billion if reductions in quality of life are included) [5]
A unique finding from this study is the idea that clinicians can change a patient’s knowledge, beliefs, and attitudes regarding pain during pain programs, but it appears that patients must deem these changes to have personal relevance in order for the changes to have a significant impact on them
Summary
Persistent pain creates an enormous biopsychosocial burden. The most frequent cause of years lived with disability globally is persistent low back pain, and other frequent causes include chronic neck pain, osteoarthritis, musculoskeletal disorders, migraine, and medication overuse headache [1]. 15.5% of work absence is due to back pain [4], and in terms of financial impacts, a 2018 report estimates that overall annual costs of persistent pain in Australia exceed AU$73 billion (AU$139 billion if reductions in quality of life are included) [5]. To address this burden, multidisciplinary pain management programs are the gold standard approach for the treatment of persistent pain, targeting changes in beliefs and behaviors, and encouraging acceptance, coping, and self-management. Conclusions: This study provides new insights into aspects of a pain management program that were perceived as valuable and impactful, areas that “missed the mark”, and hypotheses to guide the implementation of service delivery and program redesign
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