Kenda Stewart Steffensmeier1, Jennifer Van Tiem2, Ashlie Obrecht2, Mandy Conrad3, Mark W Vander Weg4, Katherine Hadlandsmyth5. 1. From the Office of Rural Health, Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa; Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa. Electronic address: kenda.steffensmeier@va.gov. 2. From the Office of Rural Health, Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa; University of Iowa, College of Education, Department of Psychological and Quantitative Foundations, Iowa City, Iowa. 3. From the Office of Rural Health, Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa; University of Iowa, College of Education, Department of Psychological and Quantitative Foundations, Iowa City, Iowa; Stanford University School of Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Division of Pain Medicine, Palo Alto, California. 4. From the Office of Rural Health, Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa; University of Iowa, College of Education, Department of Psychological and Quantitative Foundations, Iowa City, Iowa; University of Iowa, College of Public Health, Department of Community and Behavioral Health, Iowa City, Iowa. 5. From the Office of Rural Health, Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa; University of Iowa, College of Education, Department of Psychological and Quantitative Foundations, Iowa City, Iowa; University of Iowa, Carver College of Medicine, Department of Anesthesia, Iowa City, Iowa.
Abstract
PURPOSE: Preoperatively distressed patients are at elevated risk for chronic postsurgical pain. Active psychological interventions show promise for mitigating chronic postsurgical pain. This study describes experiences of preoperatively distressed (elevated depressive symptom, anxious symptoms, or pain catastrophizing) and non-distressed participants who participated in the psychologically based Perioperative Pain Self-management (PePS) intervention. DESIGN: This is a qualitative study designed to capture participants' perspectives and feedback about their experiences during the PePS intervention. METHODS: Interviews were semi-structured, conducted by telephone, audio-recorded, transcribed, and audited for accuracy. Coded interviews were analyzed using a quote matrix to discern possible qualitative differences in what preoperatively distressed and non-distressed participants found most and least helpful about the intervention. RESULTS: Twenty-one participants completed interviews, 7 of whom were classified as distressed. Distressed participants identified learning how to reframe their pain as the most helpful part of the intervention. Non-distressed participants focused on the benefit of relaxation skill-building to manage post-surgical pain. Distressed and non-distressed participants both emphasized the importance of the social support aspects of PePS and- identified goal-setting as challenging. CONCLUSIONS: Distressed and non-distressed participants emphasized different preferences for pain management strategies offered by PePS. Most participants emphasized the importance of social support that PePS provided. CLINICAL IMPLICATIONS: Our results indicate that post-operative patients may benefit from interpersonal interaction with a trained interventionist. Our findings also suggest that distressed and non-distressed patients may benefit from varied intervention approaches. How to build flexibility into a manualized intervention or whether these subsets of patients would benefit more from different interventions is a direction for future research. Published by Elsevier Inc.
PURPOSE: Preoperatively distressed patients are at elevated risk for chronic postsurgical pain. Active psychological interventions show promise for mitigating chronic postsurgical pain. This study describes experiences of preoperatively distressed (elevated depressive symptom, anxious symptoms, or pain catastrophizing) and non-distressed participants who participated in the psychologically based Perioperative Pain Self-management (PePS) intervention. DESIGN: This is a qualitative study designed to capture participants' perspectives and feedback about their experiences during the PePS intervention. METHODS: Interviews were semi-structured, conducted by telephone, audio-recorded, transcribed, and audited for accuracy. Coded interviews were analyzed using a quote matrix to discern possible qualitative differences in what preoperatively distressed and non-distressed participants found most and least helpful about the intervention. RESULTS: Twenty-one participants completed interviews, 7 of whom were classified as distressed. Distressed participants identified learning how to reframe their pain as the most helpful part of the intervention. Non-distressed participants focused on the benefit of relaxation skill-building to manage post-surgical pain. Distressed and non-distressed participants both emphasized the importance of the social support aspects of PePS and- identified goal-setting as challenging. CONCLUSIONS: Distressed and non-distressed participants emphasized different preferences for pain management strategies offered by PePS. Most participants emphasized the importance of social support that PePS provided. CLINICAL IMPLICATIONS: Our results indicate that post-operative patients may benefit from interpersonal interaction with a trained interventionist. Our findings also suggest that distressed and non-distressed patients may benefit from varied intervention approaches. How to build flexibility into a manualized intervention or whether these subsets of patients would benefit more from different interventions is a direction for future research. Published by Elsevier Inc.
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