BACKGROUND: Few qualitative studies of cancer patients' everyday experiences with pain exist within the large body of cancer pain research. Longitudinal qualitative studies are particularly sparse, and no studies have qualitatively described patients' pain experience over time during participation in a self-management intervention. OBJECTIVE: To longitudinally describe patients' pain experiences during a 10-week pain self-management intervention. METHODS: This qualitative study was embedded in a randomized controlled trial of a psychoeducational pain management intervention. The data consisted of transcribed audio recordings of each intervention session. An emergent, interpretive approach was used in this longitudinal qualitative analysis. RESULTS: Forty-two adult patients were included. The analysis revealed the strikingly dynamic nature of individual patient's pain experiences. Multiple facets of pain contributed to its dynamic nature, including pain in changing locations, co-occurring sources of pain, and varying patterns of pain intensity over time. For individual patients, the cumulative effect of these multiple facets resulted in a phenomenon we termed "complex pain dynamics." CONCLUSION: The results contribute to knowledge about the dynamic nature of cancer patients' pain experiences over a relatively short period. They suggest the need for a new paradigm for management of pain in cancer patients and raise questions about the interpretation of randomized controlled trial results in the absence of qualitative data. IMPLICATIONS FOR PRACTICE: Frequent assessments and reassessments of pain are needed in cancer patients with the ongoing development of highly individualized self-management strategies. A large repertoire of interventions is needed to effectively manage pain in cancer patients over time.
BACKGROUND: Few qualitative studies of cancer patients' everyday experiences with pain exist within the large body of cancer pain research. Longitudinal qualitative studies are particularly sparse, and no studies have qualitatively described patients' pain experience over time during participation in a self-management intervention. OBJECTIVE: To longitudinally describe patients' pain experiences during a 10-week pain self-management intervention. METHODS: This qualitative study was embedded in a randomized controlled trial of a psychoeducational pain management intervention. The data consisted of transcribed audio recordings of each intervention session. An emergent, interpretive approach was used in this longitudinal qualitative analysis. RESULTS: Forty-two adult patients were included. The analysis revealed the strikingly dynamic nature of individual patient's pain experiences. Multiple facets of pain contributed to its dynamic nature, including pain in changing locations, co-occurring sources of pain, and varying patterns of pain intensity over time. For individual patients, the cumulative effect of these multiple facets resulted in a phenomenon we termed "complex pain dynamics." CONCLUSION: The results contribute to knowledge about the dynamic nature of cancer patients' pain experiences over a relatively short period. They suggest the need for a new paradigm for management of pain in cancer patients and raise questions about the interpretation of randomized controlled trial results in the absence of qualitative data. IMPLICATIONS FOR PRACTICE: Frequent assessments and reassessments of pain are needed in cancer patients with the ongoing development of highly individualized self-management strategies. A large repertoire of interventions is needed to effectively manage pain in cancer patients over time.
Authors: Karen L Schumacher; Vicki L Plano Clark; Claudia M West; Marylin J Dodd; Michael W Rabow; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2014-04-04 Impact factor: 3.612
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Authors: M H J van den Beuken-van Everdingen; J M de Rijke; A G Kessels; H C Schouten; M van Kleef; J Patijn Journal: Ann Oncol Date: 2007-03-12 Impact factor: 32.976
Authors: Marieke H J van den Beuken-van Everdingen; Laura M J Hochstenbach; Elbert A J Joosten; Vivianne C G Tjan-Heijnen; Daisy J A Janssen Journal: J Pain Symptom Manage Date: 2016-04-23 Impact factor: 3.612
Authors: Karen L Schumacher; Vicki L Plano Clark; Claudia M West; Marylin J Dodd; Michael W Rabow; Christine Miaskowski Journal: J Pain Symptom Manage Date: 2014-04-05 Impact factor: 3.612
Authors: Christine J McPherson; Thomas Hadjistavropoulos; Alana Devereaux; Michelle M Lobchuk Journal: BMC Palliat Care Date: 2014-08-08 Impact factor: 3.234
Authors: K F Giannitrapani; M J Silveira; A Azarfar; P A Glassman; S J Singer; S M Asch; A M Midboe; M A Zenoni; R C Gamboa; W C Becker; K A Lorenz Journal: J Gen Intern Med Date: 2021-05-04 Impact factor: 6.473