Keen, S, Lomeli-Rodriguez, M and Williams, ACDC (2021) Exploring how people with chronic pain understand their pain: a qualitative study. Scandinavian Journal of Pain, 21 (4). pp. 743-753. ISSN 1877-8860

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Abstract

Objectives A fundamental principle of pain management is educating patients on their pain using current neuroscience. However, current pain neurophysiology education (PNE) interventions show variable success in improving pain outcomes, and may be difficult to integrate with existing understanding of pain. This study aimed to investigate how people with chronic pain understand their pain, using qualitative exploration of their conceptualisations of pain, and how this understanding accommodated, or resisted, the messages of PNE. Methods Twelve UK adults with chronic pain were recruited through advertisements on online pain networks. Semi-structured interviews were conducted remotely, with responses elicited using the Grid Elaboration Method (GEM) and then a PNE article. Participants’ grid elaborations and responses to PNE were analysed using thematic analysis (TA). Results Three main themes were extracted from participants' grid elaborations: communicating pain, explaining pain and living with pain. These themes incorporated varied, inconsistent sub-themes: of pain as simultaneously experiential and conceptual; in the body and in the mind; diagnosable and inexplicable; manageable and insuperable. Generalised, meta-level agreement was identified in participants' PNE responses, but with doubts about its practical value. Conclusions This study shows that people understand pain through inconsistent experiential models that may resist attempts at conceptual integration. Participants' elaborations showed diverse and dissonant conceptualisations, with experiential themes of restricted living; assault on the self; pursuit of understanding pain and abandonment of that pursuit. Responses, although unexpectedly compatible with PNE, suggested that PNE was perceived as intellectually engaging but practically inadequate. Experiential disconfirmation may be required for behavioural change inhibited by embedded fears and aversive experiences.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences; 3202 Clinical sciences; 4201 Allied health and rehabilitation science
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Psychology (from Sep 2019)
Publisher:	De Gruyter
SWORD Depositor:	A Symplectic
Date Deposited:	28 Mar 2025 12:05
Last Modified:	28 Mar 2025 12:05
DOI or ID number:	10.1515/sjpain-2021-0060
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26030

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