Document Type : Original Article
Authors
Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
Abstract
Background: Given the chronic pain management complexities, achieving a model for managing chronic pain psychological dimensions is very important. Hence, the current study aimed to design a psychological empowerment model in chronic pain management.
Methods: This qualitative method was conducted using a grounded theory approach; the main method of data collection was semi-structured interviews and participant observation. The participants were 15 members of the treatment team and six patients with chronic pain, selected via theoretical and purposive sampling from 2018 to 2020. Data analysis was performed concurrently with data gathering based on Corbin and Strauss’s proposed method. Data validity was confirmed via Lincoln and Guba’s criteria.
Results: The developed psychological empowerment model in chronic pain management consists of six constructs including “pain reasoning”, “vulnerability”, “pain interactions”, “ailment”, “facing pain”, and “self-empowerment”. Among them “self-empowerment” was identified as the major concept or core category. The themes of pain reasoning and vulnerability were identified as the cause and background , respectively, which affected the phenomenon of ailment. In this regard, the themes pain interactions and facing pain were also recognized as the interferers and approaches which lead to self-empowerment like the consequences, if implemented properly.
Conclusion: The developed model in this study, as a caring model, can be used for compensating the lack of attention to chronic pain psychological dimensions in chronic pain management. Its use in clinical settings requires further studies on testing the above model on patients with chronic pain.
Keywords
- Bonezzi C, Fornasari D, Cricelli C, Magni A, Ventriglia G. Not All Pain is Created Equal: Basic Definitions and Diagnostic Work-Up. Pain and Therapy. 2020; 9(1):1-15.
- Mathieson S, Wertheimer G, Maher CG, Christine Lin CW, McLachlan AJ, Buchbinder R, et al. What proportion of patients with chronic non cancer pain are prescribed an opioid medicine? Systematic review and meta-regression of observational studies. J Intern Med. 2020; 287(5):458-74.
- Rajappa H, Hayes C. People, medicine, and society: An overview of chronic pain management. Archives of Medicine and Health Sciences. 2020; 8(1):68-74.
- de Souza JB, Grossmann E, Perissinotti DMN, de Oliveira Junior JO, da Fonseca PRB, Posso IP. Prevalence of chronic pain, treatments, perception, and interference on life activities: Brazilian population-based survey. Pain Res Manag. 2017; 2017:4643830.
- Alighias M, Tavafian SS, Niknami S. psychological intervention and pain severity among a sample of iranian nurses suffering from chronic low back pain: A randomized clinical trial. Int J Musculoskeletal Pain Prev. 2016; 1(1):1-5.
- Taghipour-Darzi M, Hosseini SR, Kia K, Abbaspour M, Ghadimi R. Prevalence of musculoskeletal pain and it's correlation to functional disability in elderly. Knowledge Health. 2013:8(2):76-83.
- Dorner TE. Pain and chronic pain epidemiology: Implications for clinical and public health fields. Wien Klin Wochenschr. 2018; 130(1-2):1-3.
- Smith TJ, Hillner BE. The cost of pain the cost of pain was more than that of heart disease and cancer treatments. JAMA Netw Open. 2019; 2(4):e191532.
- Park R, Ho AM, Pickering G, Arendt-Nielsen L, Mohiuddin M, Gilron I. Magnesium for the management of chronic noncancer pain in adults: protocol for a systematic review. JMIR Res Protoc. 2019; 8(1):e11654.
- Yongjun Z, Tingjie Z, Xiaoqiu Y, Zhiying F, Feng Q, Guangke X, et al. A survey of chronic pain in China. Libyan J Med. 2020; 15(1):1730550.
- Devan H, Hale L, Hempel D, Saipe B, Perry MA. What works and does not work in a self-management intervention for people with chronic pain? Qualitative systematic review and meta-synthesis. Phys Ther. 2018; 98(5):381-97.
- Bailo L, Guiddi P, Vergani L, Marton G, Pravettoni G. The patient perspective: investigating patient empowerment enablers and barriers within the oncological care process. Ecancermedicalscience. 2019; 13:912.
- World Health Organization. A European policy framework and strategy for the 21st century World Heal Organ 182 .2013.
- Small N, Bower P, Chew-Graham CA, Whalley D, Protheroe J. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res. 2013; 13:263.
- Marshall Rio J. Understanding motivation and emotion. Mohammadi SY. (Persian). Tehran: Virayesh Publication; 2017.
- Kaveh M, Zare S, Ghahremani L, Nazari, M. Quality of life in diabetic patients: the predicting role of personal resources. J Health Sci Surv Sys. 2018; 6(3):142-148.
- Murphy K, Casey D, Devane D, Cooney A, McCarthy B, Mee L, et al. A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD): The PRINCE Study protocol. BMC Pulm Med. 2011; 11:4.
- Te Boveldt N, Vernooij-Dassen M, Leppink I, Samwel H, Vissers K, Engels Y. Patient empowerment in cancer pain management: an integrative literature review. Psychooncology. 2014; 23(11):1203-11.
- Hambraeus J, Hambraeus KS, Sahlen KG. Patient perspectives on interventional pain management: thematic analysis of a qualitative interview study. BMC Health Serv Res. 2020; 20(1):604.
- Corbin JM, Strauss AL, Basics of qualitative research: Techniques and procedures for developing grounded theory: Sage Publications, Inc. 2008.
- Polit DF, Beck CT. Nursing Research: Principles and Methods (Nursing Research: Principles & Practice) 7th Edition; Publisher: Lippincott Williams & Wilkins; 7th edition. 2003.
- Polacek C, Christopher R, Mann M, Udall M, Craig T, Deminski M, et al. Healthcare professionals' perceptions of challenges to chronic pain management. Am J Manag Care. 2020; 26(4):e135-e9.
- Australian Institute of Health and Welfare. Chronic pain in Australia. Canberra: AIHW; 2020.
- Alschuler KN, Kratz AL, Ehde DM. Resilience and vulnerability in individuals with chronic pain and physical disability. Rehabil Psychol. 2016; 61(1):7-18.
- Shirazi M, Manoochehri H, Zagheri Tafreshi M, Zayeri F, Alipour V. Testing of comprehensive chronic pain management model in older people. Journal of Anesthesiology and Pain. 2016; 7(1):49-62.
- Almeida B, Capela A, Pinto J, Santos V, Silva CG, Rosa MCN. Relationship between the perceived social support and catastrophization in individuals with chronic knee pain. BrJP. 2019; 2:55-60.
- Kumar P, Tripathi L. Challenges in pain assessment: Pain intensity scales. Indian Journal of Pain. 2014; 28(2):61-70.
- Abrahams N, Gilson L, Levitt NS, Dave JA. Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa. BMC Endocrine Disorders. 2019; 19(1):133.
- Bostick GP, Carroll LJ, Brown CA, Harley D, Gross DP. Predictive capacity of pain beliefs and catastrophizing in Whiplash Associated Disorder. Injury. 2013; 44(11):1465-71.
- McCracken LM, Eccleston C. Coping or acceptance: what to do about chronic pain? Pain. 2003; 105(1-2):197-204.
- Gentili C, Rickardsson J, Zetterqvist V, Simons LE, Lekander M, Wicksell RK. Psychological Flexibility as a Resilience Factor in Individuals with Chronic Pain. Front Psychol. 2019; 10:2016.
- Ramírez-Maestre C, de la Vega R, Sturgeon JA, Peters M. Editorial: Resilience Resources in Chronic Pain Patients: The Path to Adaptation. Frontiers in psychology. 2019; 10:2848.
- Daruwalla Z, Thakkar V, Aggarwal M, Kiasatdolatabadi A, Guergachi A, Keshavjee K. Patient Empowerment: The Role of Technology. Stud Health Technol Inform. 2019; 257:70-4.
- Koechlin H, Locher C, Prchal A. Talking to Children and Families about Chronic Pain: The Importance of Pain Education-An Introduction for Pediatricians and Other Health Care Providers. Children (Basel). 2020; 7(10).
- Sharma S, Breckons M, Brönnimann Lambelet B, Chung J-W, List T, Lobbezoo F, et al. Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain. Journal of Oral Rehabilitation. 2020; 47(1):87-100.