Wijma Amarins J, Speksnijder Caroline M, Crom-Ottens Astrid F, Knulst-Verlaan J M Corine, Keizer Doeke, Nijs Jo, van Wilgen C Paul
a Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy , Vrije Universiteit Brussel , Brussels , Belgium.
b Transcare, Transdisciplinary Pain Management Center , Groningen , The Netherlands.
Disabil Rehabil. 2018 Sep;40(18):2181-2191. doi: 10.1080/09638288.2017.1327990. Epub 2017 May 19.
The main focus of Pain Neuroscience Education is around changing patients' pain perceptions and minimizing further medical care. Even though Pain Neuroscience Education has been studied extensively, the experiences of patients regarding the Pain Neuroscience Education process remain to be explored. Therefore, the aim of this study was to explore the experiences in patients with non-specific chronic pain.
Fifteen patients with non-specific chronic pain from a transdisciplinary treatment centre were in-depth interviewed. Data collection and analysis were performed according to Grounded Theory.
Five interacting topics emerged: (1) "the pre-Pain Neuroscience Education phase", involving the primary needs to provide Pain Neuroscience Education, with subthemes containing (a) "a broad intake" and (b) "the healthcare professionals"; (2) "a comprehensible Pain Neuroscience Education" containing (a) "understandable explanation" and (b) "interaction between the physiotherapist and psychologist"; (3) "outcomes of Pain Neuroscience Education" including (a) "awareness", b) "finding peace of mind", and (c) "fewer symptoms"; 4) ""scepticism" containing (a) "doubt towards the diagnosis and Pain Neuroscience Education", (b) "disagreement with the diagnosis and Pain Neuroscience Education", and (c) "Pain Neuroscience Education can be confronting".
This is the first study providing insight into the constructs contributing to the Pain Neuroscience Education experience of patients with non-specific chronic pain. The results reveal the importance of the therapeutic alliance between the patient and caregiver, taking time, listening, providing a clear explanation, and the possible outcomes when doing so. The findings from this study can be used to facilitate healthcare professionals in providing Pain Neuroscience Education to patients with non-specific chronic pain. Implications for Rehabilitation An extensive biopsychosocial patient centred intake is crucial prior to providing Pain Neuroscience Education. Repetitions of Pain Neuroscience Education, in different forms (verbal and written information, examples, drawings, etc.) help patients to understand the theory of neurophysiology. Pain Neuroscience Education induces insight into the patient's complaints, improved coping with complaints, improved self-control, and induces in some cases peace of mind. Healthcare professionals providing Pain Neuroscience Education should be aware of the possible confronting nature of the contributing factors.
疼痛神经科学教育的主要重点是改变患者的疼痛认知并尽量减少进一步的医疗护理。尽管对疼痛神经科学教育进行了广泛研究，但患者在疼痛神经科学教育过程中的体验仍有待探索。因此，本研究的目的是探索非特异性慢性疼痛患者的体验。
对来自跨学科治疗中心的15名非特异性慢性疼痛患者进行了深入访谈。根据扎根理论进行数据收集和分析。
出现了五个相互关联的主题：（1）“疼痛神经科学教育前阶段”，涉及提供疼痛神经科学教育的主要需求，子主题包括（a）“广泛的问诊”和（b）“医护人员”；（2）“可理解的疼痛神经科学教育”，包括（a）“易懂的解释”和（b）“物理治疗师与心理学家之间的互动”；（3）“疼痛神经科学教育的结果”，包括（a）“意识”、（b）“内心平静”和（c）“症状减轻”；（4）“怀疑”，包括（a）“对诊断和疼痛神经科学教育的怀疑”、（b）“对诊断和疼痛神经科学教育的不同意见”以及（c）“疼痛神经科学教育可能令人不安”。
这是第一项深入了解影响非特异性慢性疼痛患者疼痛神经科学教育体验因素的研究。结果揭示了患者与护理人员之间治疗联盟的重要性，包括花费时间、倾听、提供清晰解释以及这样做可能产生的结果。本研究结果可用于帮助医护人员为非特异性慢性疼痛患者提供疼痛神经科学教育。对康复的启示 在提供疼痛神经科学教育之前，以患者为中心进行广泛的生物心理社会问诊至关重要。以不同形式（口头和书面信息、示例、图表等）重复进行疼痛神经科学教育有助于患者理解神经生理学理论。疼痛神经科学教育能使患者深入了解自身症状，改善应对症状的能力，增强自我控制能力，并在某些情况下带来内心平静。提供疼痛神经科学教育的医护人员应意识到相关因素可能具有的挑战性。
