Anthony M Harrison1, Angeliki Bogosian1, Eli Silber2, Lance M McCracken1, Rona Moss-Morris3. 1. Health Psychology Section, Institute of Psychiatry, King's College London, UK. 2. MS Specialist Outpatient Neurology Service, King's College London, UK. 3. Health Psychology Section, Institute of Psychiatry, King's College London, UK rona.moss-morris@kcl.ac.uk.
Abstract
BACKGROUND: Pain affects around 63% of people with multiple sclerosis (pwMS). Biomedical treatments demonstrate limited efficacy. More research is needed to understand pain from the individual's perspective in order to better inform a patient-centred approach that improves engagement, self-management and outcome. OBJECTIVE: The objective of this paper is to explore pwMS' experience and responses to pain, and their perspectives on pain management. METHODS: Twenty-five in-depth, semi-structured telephone interviews were conducted. Interviews were audiotaped, transcribed and analysed using an inductive thematic analysis approach with elements of grounded theory. RESULTS: Key themes included vivid descriptions of pain and beliefs that pain is unpredictable, a sign of damage and may worsen. Anger was a common emotional response. Two dominant pain management themes emerged: one related to pain reduction and another to acceptance. Those focusing on pain reduction appeared to engage in cycles in which they struggled with symptoms and experienced continued distress. CONCLUSION: Findings identify pain-related beliefs, emotional reactions and disparate pain-management attitudes. All may influence pwMS' responses to pain and what they ask of their clinicians. Uncovering pwMS' personal beliefs about pain, and introducing a broader biopsychosocial understanding of pain in the clinical context, may provide opportunities to rectify potentially unhelpful management choices and enhance pain acceptance.
BACKGROUND:Pain affects around 63% of people with multiple sclerosis (pwMS). Biomedical treatments demonstrate limited efficacy. More research is needed to understand pain from the individual's perspective in order to better inform a patient-centred approach that improves engagement, self-management and outcome. OBJECTIVE: The objective of this paper is to explore pwMS' experience and responses to pain, and their perspectives on pain management. METHODS: Twenty-five in-depth, semi-structured telephone interviews were conducted. Interviews were audiotaped, transcribed and analysed using an inductive thematic analysis approach with elements of grounded theory. RESULTS: Key themes included vivid descriptions of pain and beliefs that pain is unpredictable, a sign of damage and may worsen. Anger was a common emotional response. Two dominant pain management themes emerged: one related to pain reduction and another to acceptance. Those focusing on pain reduction appeared to engage in cycles in which they struggled with symptoms and experienced continued distress. CONCLUSION: Findings identify pain-related beliefs, emotional reactions and disparate pain-management attitudes. All may influence pwMS' responses to pain and what they ask of their clinicians. Uncovering pwMS' personal beliefs about pain, and introducing a broader biopsychosocial understanding of pain in the clinical context, may provide opportunities to rectify potentially unhelpful management choices and enhance pain acceptance.
Authors: Jane Desborough; Crystal Brunoro; Anne Parkinson; Katrina Chisholm; Mark Elisha; Janet Drew; Vanessa Fanning; Christian Lueck; Anne Bruestle; Matthew Cook; Hanna Suominen; Antonio Tricoli; Adam Henschke; Christine Phillips Journal: Health Expect Date: 2020-06-24 Impact factor: 3.377