Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Scand J Pain. 2021 Feb 1;21(2):296-307. doi: 10.1515/sjpain-2020-0149. Print 2021 Apr 27.
Chronic neuropathic pain is common in people living with HIV. Psychological treatments can improve quality of life for people with chronic pain in general, and online delivery can increase access to these treatments. However, the acceptability of psychological treatment and online delivery have not been investigated in-depth in people living with HIV and chronic neuropathic pain. Therefore, a qualitative study was undertaken to explore views about a psychological treatment for pain management in this population and to investigate the acceptability of online treatment delivery.
Qualitative interviews were conducted and analysed using inductive thematic analysis, adopting a critical realist perspective. Twenty-six people living with HIV and chronic neuropathic pain completed semi-structured interviews. Their views about a psychological treatment for pain management and online delivery were explored in-depth.
Three themes and 12 subthemes were identified. Theme one represents a desire for a broader approach to pain management, including not wanting to take more pills and having multidimensional goals that were not just focussed on pain relief. Theme two includes barriers to online psychologically-based pain management, including concerns about using the Internet and confidentiality. Theme three describes treatment facilitators, including accessibility, therapist support, social connection, and experiencing success.
A psychological treatment for chronic neuropathic pain management appears acceptable for people living with HIV. Therapist-supported online delivery of cognitive-behavioural pain management may be acceptable for people living with HIV given appropriate development of the treatment to address identified barriers to engagement. These data can inform developments to enhance engagement in online psychologically-informed pain management in people living with HIV and more broadly in remote delivery of psychological treatments.
慢性神经性疼痛在 HIV 感染者中较为常见。心理治疗一般可以改善慢性疼痛患者的生活质量，而在线治疗可以增加获得这些治疗的机会。然而，在 HIV 感染者和慢性神经性疼痛患者中，尚未深入研究心理治疗和在线治疗的可接受性。因此，进行了一项定性研究，以探讨人们对治疗该人群疼痛管理的心理治疗的看法，并调查在线治疗交付的可接受性。
采用诱导主题分析方法，采用批判现实主义观点，对 26 名 HIV 感染者和慢性神经性疼痛患者进行了定性访谈和分析。深入探讨了他们对疼痛管理的心理治疗和在线交付的看法。
确定了三个主题和 12 个子主题。主题一代表了对疼痛管理更广泛方法的渴望，包括不想服用更多药物以及具有多维目标，而不仅仅是关注疼痛缓解。主题二包括在线心理疼痛管理的障碍，包括对互联网的使用和保密性的担忧。主题三描述了治疗促进因素，包括可及性、治疗师支持、社交联系和体验成功。
对于 HIV 感染者来说，慢性神经性疼痛管理的心理治疗似乎是可以接受的。鉴于认知行为疼痛管理的治疗方法存在明确的参与障碍，在适当开发治疗方法以解决这些障碍的前提下，在线提供以治疗师支持为基础的认知行为疼痛管理可能是可以接受的。这些数据可以为改善 HIV 感染者在线心理干预疼痛管理的参与度以及更广泛地远程提供心理治疗提供信息。
