Lovette Brenda C, Bannon Sarah M, Spyropoulos Daphne Catherine, Vranceanu Ana-Maria, Greenberg Jonathan
Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA.
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
J Pain Res. 2022 Jul 29;15:2139-2148. doi: 10.2147/JPR.S372469. eCollection 2022.
Chronic orofacial pain is prevalent and debilitating. Psychological and social factors place a heavy burden on this population but are often overlooked. Here, we offer the first comprehensive qualitative conceptualization of the challenges of living with chronic orofacial pain through a biopsychosocial perspective to inform multifaceted care for this population.
We employed a qualitative thematic analysis of open text responses using a hybrid inductive-deductive approach and a biopsychosocial framework.
Two hundred and sixty participants with chronic orofacial pain responded to an open-ended question: "What is the biggest challenge you face in managing your condition?" by typing their responses into a text box as part of an online survey. We mapped responses onto biomedical, psychological, and social themes (deductive) and concurrently identified findings within each theme that emerged directly from the data (inductive).
Subthemes within the biomedical theme included challenges with biomedical pain management, medication side effects, sensory triggers, physical symptoms of stress/tension, and biological functions and related activities of daily living. Subthemes within the psychological theme included anxiety, depression, emotional symptoms of stress, unpredictability/uncertainty of pain, and psychological and cognitive aspects of medication management. Subthemes within the social theme included social relational, experience with providers, socioeconomics and access to care, and roles and responsibilities.
Chronic orofacial pain is associated with multifaceted challenges. Consideration of individuals' experiences of biomedical, psychological, and social challenges in the assessment, referral, and treatment of chronic orofacial pain holds the potential to promote more comprehensive, patient-centered care for this population.
慢性口面部疼痛普遍存在且使人衰弱。心理和社会因素给这一群体带来沉重负担，但往往被忽视。在此，我们通过生物心理社会视角首次对慢性口面部疼痛患者生活中的挑战进行了全面的定性概念化，以为该群体的多方面护理提供参考。
我们采用混合归纳 - 演绎方法和生物心理社会框架，对开放式文本回复进行定性主题分析。
260名慢性口面部疼痛患者回答了一个开放式问题：“在管理你的病情时，你面临的最大挑战是什么？”，他们通过在在线调查的文本框中输入回复来作答。我们将回复映射到生物医学、心理和社会主题（演绎），并同时识别每个主题中直接从数据中浮现的发现（归纳）。
生物医学主题中的子主题包括生物医学疼痛管理的挑战、药物副作用、感觉触发因素、压力/紧张的身体症状以及生物功能和相关日常生活活动。心理主题中的子主题包括焦虑、抑郁、压力的情绪症状、疼痛的不可预测性/不确定性以及药物管理的心理和认知方面。社会主题中的子主题包括社会关系、与医疗服务提供者的经历、社会经济状况和医疗服务可及性，以及角色和责任。
慢性口面部疼痛与多方面的挑战相关。在慢性口面部疼痛的评估、转诊和治疗中考虑个体在生物医学、心理和社会方面的挑战经历，有可能为该群体促进更全面、以患者为中心的护理。
