Wideman Timothy H, Boom Alice, Dell'Elce Jennifer, Bergeron Kate, Fugère Janick, Lu Xiangying, Bostick Geoff, Lambert Heather C
School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
Pain Res Manag. 2016;2016:9570581. doi: 10.1155/2016/9570581. Epub 2016 Dec 14.
Chronic pain negatively impacts health, well-being, and social participation. Effective rehabilitation often hinges on long-term changes in pain-related perceptions and behaviors. However, there are important gaps in understanding how patients perceive these changes. The present pilot study addresses this gap by using qualitative and quantitative methodologies to explore how patients perceive and experience changes in function, participation, and pain-related factors following a chronic pain rehabilitation program. A mixed-method design was used in which the core method was qualitative. Descriptive quantitative data was used to further characterize the sample. Semistructured interviews were conducted 1-6 months following treatment completion. Questionnaires were administered before and after treatment and at follow-up. Interview data was analyzed thematically. Participants' individual descriptive data was compared to established cut-scores and criteria for change. A major theme of personal growth emerged in the qualitative analysis. Participants also discussed the factors that facilitated personal growth and the ongoing challenges to this growth. The quantitative data revealed limited improvement on measures of pain, disability, catastrophizing, and depression. These findings suggest that, despite limited improvement on treatment-related questionnaires, patients can experience an important and enduring sense of personal growth. Clinical and theoretical implications are discussed.
慢性疼痛会对健康、幸福感和社会参与产生负面影响。有效的康复通常取决于疼痛相关认知和行为的长期改变。然而，在理解患者如何看待这些变化方面存在重大差距。本试点研究通过使用定性和定量方法来探讨患者在慢性疼痛康复计划后如何感知和体验功能、参与度以及疼痛相关因素的变化，从而解决了这一差距。采用了混合方法设计，其中核心方法是定性的。描述性定量数据用于进一步描述样本特征。在治疗完成后的1 - 6个月进行半结构化访谈。在治疗前后及随访时发放问卷。对访谈数据进行主题分析。将参与者的个人描述性数据与既定的临界分数和变化标准进行比较。定性分析中出现了个人成长这一主要主题。参与者还讨论了促进个人成长的因素以及这种成长面临的持续挑战。定量数据显示，在疼痛、残疾、灾难化思维和抑郁测量方面改善有限。这些发现表明，尽管与治疗相关的问卷上改善有限，但患者仍可体验到重要且持久的个人成长感。文中讨论了临床和理论意义。
