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Mbarga J, Favre C, Ribeiro C, Pichonnaz C, Ancey C, Foley RA, Leger B, Luthi F. Beyond activity patterns: The complex process of activity management among individuals with chronic musculoskeletal pain after an orthopaedic trauma. Eur J Pain 2024. [PMID: 38294106 DOI: 10.1002/ejp.2246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
CONTEXT Individuals must change the way they perform activities in response to chronic pain. In the literature, three activity patterns are commonly described: avoidance, pacing, and persistence. Many studies have explored these activity patterns. However, little research has delved into the factors that lead people to adopt a particular activity behaviour. This study aimed to explore the relationship that people with chronic musculoskeletal pain have with activity and highlight the factors underlying their practices. METHODS The qualitative study was conducted by researchers in the social sciences, physiotherapy, psychology, and rehabilitation medicine. Observations of vocational workshops and semi-structured interviews were conducted with 33 persons undergoing rehabilitation for chronic musculoskeletal pain after an accident. RESULTS Patients' declarations and actions show that any one patient will alternate between activity patterns: the same person may adopt a strategy of avoidance, pacing or persistence depending on the context, the importance of the activity, personal objectives, and representations of self, pain, and activity. The decision to engage in a particular behaviour is based on a process of self-negotiation weighted by the circumstances, the nature of the activity, the importance attached to it, and the individual's perceived ability. CONCLUSION Our study emphasized the complexity of physical, social, and contextual factors that intervene in the relationship toward activity. Rather than favouring pacing, the therapist's role in rehabilitation might be to reinforce the reflexive process and the patient's adaptability in approaching the activity, to foster the capacity to find flexible solutions. SIGNIFICANCE Patients choose an activity pattern (avoidance, pacing, persistence) according to the challenges they face in their daily lives. Context, representations of self and activity, as well as goals sought influence these choices. Some patients report having learned to adapt their activity management strategies. Therefore, therapeutic approaches in the rehabilitation context could focus on these adaptive capacities to offer patients optimal pain and activity management and develop their ability to use different strategies according to the circumstance.
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Affiliation(s)
- J Mbarga
- Department of Applied Research and Development, HESAV School of Health Sciences - HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - C Favre
- Department of Psychosomatic, Clinique Romande de Réadaptation, Sion, Switzerland
| | - C Ribeiro
- Department of Applied Research and Development, HESAV School of Health Sciences - HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - C Pichonnaz
- Department of Physiotherapy, HESAV School of Health Sciences - HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - C Ancey
- Department of Physiotherapy, HESAV School of Health Sciences - HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - R-A Foley
- Department of Applied Research and Development, HESAV School of Health Sciences - HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - B Leger
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - F Luthi
- Department of Musculoskeletal Rehabilitation and Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
- Division of Physical Medicine and Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
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van Rysewyk S, Blomkvist R, Chuter A, Crighton R, Hodson F, Roomes D, Smith BH, Toye F. Understanding the lived experience of chronic pain: A systematic review and synthesis of qualitative evidence syntheses. Br J Pain 2023; 17:592-605. [PMID: 37969135 PMCID: PMC10642495 DOI: 10.1177/20494637231196426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Background Although multiple measures of the causes and consequences of chronic non-cancer pain (CNCP) are available and can inform pain management, no quantitative summary of these measures can describe the meaning of pain for a patient. The lived experience of pain tends to be a blind spot in pain management. This study aimed to: (1) integrate qualitative research investigating the lived experience of a range of CNCP conditions; (2) establish common qualitative themes in CNCP experience; and (3) evaluate the relevance of our results through a survey questionnaire based on these themes, administered across the United Kingdom. Methods Four bibliographic databases were searched from inception to February 2021 to identify Qualitative Evidence Syntheses (QES) that investigated the lived experience of CNCP and its impact on everyday life and activities. Themes and trends were derived by thematic qualitative analysis in collaboration with two patient and public involvement representatives who co-created twenty survey statements. The survey was developed for testing the QES themes for validity in people living with pain. Results The research team identified and screened 1323 titles, and considered 86 abstracts, including 20 in the final review. Eight themes were developed from the study findings: (1) my pain gives rise to negative emotions; (2) changes to my life and to myself; (3) adapting to my new normal; (4) effects of my pain management strategies; (5) hiding and showing my pain; (6) medically explaining my pain; (7) relationships to those around me; and (8) working while in pain. Each theme gave rise to one or two survey questions. The survey was shared with members of the UK pain community over a 2-week period in November 2021, and was completed by 1219 people, largely confirming the above themes. Conclusion/Implications This study provides a validated summary of the lived experience of CNCP. It highlights the adverse nature, complications, and consequences of living with CNCP in the UK and the multiple shortcomings in the ways in which pain is addressed by others in the UK. Our findings are consistent with published meta-ethnographies on chronic non-malignant musculoskeletal pain and chronic low-back pain. Despite the underrepresentation of qualitative research in the pain literature compared to quantitative approaches, for understanding the complexity of the lived experience of pain, qualitative research is an essential tool.
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Affiliation(s)
- Simon van Rysewyk
- Department of Philosophy and Gender Studies, School of Humanities, University of Tasmania, Hobart, TAS, Australia
| | - Renée Blomkvist
- Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | | | - Rhea Crighton
- Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, UK
| | | | | | - Blair H Smith
- Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Francine Toye
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Nicklin D, Walumbe J, Denneny D, Godfrey E. What non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with non-malignant chronic pain? A scoping review of published literature. Br J Pain 2023; 17:546-559. [PMID: 37974635 PMCID: PMC10642497 DOI: 10.1177/20494637231196646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objectives A scoping review was selected to explore what non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with chronic pain and what represents the most appropriate intervention. Inclusion Criteria Adults with non-malignant chronic pain from Turkish-speaking ethnic groups residing in or outside of Turkey. All non-pharmacological and non-invasive pain management interventions were considered. No limits were placed on geographic location, gender, sex or healthcare setting. Methods The MEDLINE database was searched for published literature in April 2022. An English language filter was applied. No limits were placed on study design or date of publication. Data was charted from eligible studies into a data extraction table. Key concepts were identified during data extraction by DN. Results Eleven studies were included in the final review. All were conducted within a quantitative research paradigm. The studies were completed in Turkey (7), Belgium (1), Sweden (1) and Switzerland (1). One was a multi-country review. No studies were conducted in the UK. The primary interventions were heterogenous and included: pain science education (2), cognitive behavioural therapy (2), transcranial magnetic stimulation (1), balneotherapy (1), extracorporeal shockwave therapy (1), transcutaneous electrical nerve stimulation (1), wool therapy (1), exercise and patient dialogues (1) and aromatherapy massage and reflexology (1). Location of pain, outcome measures and timings of follow-ups were heterogeneous. Conclusions Intervention heterogeneity, exclusively quantitative methodology and absence of studies completed in the UK meant no conclusions could be made on what represents the most appropriate non-pharmacological and non-invasive interventions intervention for individuals from Turkish speaking ethnic groups with non-malignant chronic pain.
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Affiliation(s)
| | - Jackie Walumbe
- University College London Hospitals NHS Foundation Trust, London, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Khalili-Mahani N, Mischkowski D, Hovey RB. Editorial: Qualitative pain research: Capturing and integrating cultural, social and linguistic data. Front Pain Res (Lausanne) 2022; 3:1082044. [PMID: 36506270 PMCID: PMC9731110 DOI: 10.3389/fpain.2022.1082044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Najmeh Khalili-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | | | - Richard B. Hovey
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
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Affiliation(s)
- Julie Ayre
- Sydney Health Literacy Lab, Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Australia.
| | - Kirsten J McCaffery
- Sydney Health Literacy Lab, Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Australia
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Nabbijohn AN, Tomlinson RM, Lee S, Morrongiello BA, McMurtry CM. The Measurement and Conceptualization of Coping Responses in Pediatric Chronic Pain Populations: A Scoping Review. Front Psychol 2021; 12:680277. [PMID: 34659002 PMCID: PMC8519346 DOI: 10.3389/fpsyg.2021.680277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 08/26/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Pediatric chronic pain is a prevalent condition that requires significant coping to encourage optimal functioning; however, relevant research is vast, heterogeneous, and difficult to interpret. To date, no attempt has been made to map and summarize the measurement and conceptualization of coping responses in the context of pediatric chronic pain. Objectives: A scoping review was conducted to map and summarize the participant characteristics, methodologies, theoretical frameworks, and measures used to assess coping responses in youth with chronic pain. The extent to which authors used definitions and examples of coping responses (conceptual clarity) as well as consistently used measures (measurement consistency) and their corresponding conceptualizations (conceptual consistency) relative to how they were intended to be used were assessed. Methods: Searches were conducted through MEDLINE (PubMed) and PsycINFO. Following title/abstract screening, full-text extractions were performed on 125 English-language publications on coping in youth with chronic pain. Results: Of the 125 studies, only 12.8% used a theoretical framework to explain the coping responses assessed, and even fewer (7.2%) used theory to guide measure selection. Conceptual clarity was rated "low/very low" (i.e., no definitions and/or examples) for 47.2% of studies. The majority of studies were conducted in the United States (67%) and a preponderance of White and female participants was sampled. The research primarily used quantitative methods (85%) and cross-sectional designs (67%). Parent- or self-report questionnaires were the most common methods for assessing coping (86%). Of the 95 studies that utilized one of the 14 questionnaires with known psychometric properties, 33.7 and 55.8% had one or more discrepancies for conceptual and measurement consistency, respectively. Conclusions: This review highlights the lack of clear descriptions and theoretical frameworks of coping responses for pediatric chronic pain. Inconsistencies in the measurement and conceptualization of coping responses limit research and clinical advancements. As a field, we need to strive toward using well-developed theory to create fewer, more well-established standardized measures with clearly defined coping responses. Opportunities for qualitative and observational research in more diverse patient populations should be considered for theory construction and measure validation. Clinical Trial Registration: https://osf.io/xvn2a/?view_only=eff04e0c0b9649be89d403b10e9ff082.
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Affiliation(s)
| | | | - Soeun Lee
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | | | - C. Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph, ON, Canada
- Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton, ON, Canada
- Children's Health Research Institute and Department of Paediatrics, Schulich School of Medicine and Dentistry, London, ON, Canada
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Vader K, Bostick GP, Carlesso LC, Hunter J, Mesaroli G, Perreault K, Tousignant-Laflamme Y, Tupper S, Walton DM, Wideman TH, Miller J. The Revised IASP Definition of Pain and Accompanying Notes: Considerations for the Physiotherapy Profession. Physiother Can 2021; 73:103-106. [PMID: 34456418 PMCID: PMC8370731 DOI: 10.3138/ptc-2020-0124-gee] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Kyle Vader
- School of Rehabilitation Therapy, Queen’s University
- Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston
| | - Geoff P. Bostick
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alta
| | | | - Judith Hunter
- Department of Physical Therapy, University of Toronto
| | - Giulia Mesaroli
- Department of Physical Therapy, University of Toronto
- Department of Rehabilitation Services, Hospital for Sick Children, Toronto
| | - Kadija Perreault
- Department of Rehabilitation
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Université Laval, Quebec City
| | | | - Susan Tupper
- Saskatchewan Health Authority
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Sask
| | | | - Timothy H. Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal
| | - Jordan Miller
- School of Rehabilitation Therapy, Queen’s University
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Vader K, Bostick GP, Carlesso LC, Hunter J, Mesaroli G, Perreault K, Tousignant-Laflamme Y, Tupper S, Walton DM, Wideman TH, Miller J. La définition révisée de la douleur de l’IASP et les notes complémentaires : les considérations pour la profession de la physiothérapie. Physiother Can 2021; 73:106-109. [PMID: 34456419 PMCID: PMC8370722 DOI: 10.3138/ptc-2020-0124-gef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Kyle Vader
- École de thérapie de réadaptation, Queen’s University
- Clinique de douleur chronique, Kingston Health Sciences Centre, Kingston
| | - Geoff P. Bostick
- Faculté de médecine de réadaptation, University of Alberta, Edmonton (Alberta)
| | - Lisa C. Carlesso
- École des sciences de la réadaptation, McMaster University, Hamilton
| | - Judith Hunter
- Département de physiothérapie, University of Toronto
| | - Giulia Mesaroli
- Département de physiothérapie, University of Toronto
- Département des services de réadaptation, The Hospital for Sick Children, Toronto
| | - Kadija Perreault
- Département de réadaptation
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Université Laval, Québec
| | | | - Susan Tupper
- Autorité sanitaire de la Saskatchewan
- École des sciences de la réadaptation, University of Saskatchewan, Saskatoon (Saskatchewan)
| | - David M. Walton
- École de physiothérapie, Western University, London (Ontario)
| | | | - Jordan Miller
- École de thérapie de réadaptation, Queen’s University
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