School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Perth Scar and Pain Clinic, Mount Pleasant, WA, Australia.
Work. 2023;75(2):689-701. doi: 10.3233/WOR-220119.
People with chronic pain may seek rehabilitation to reduce pain and restore productivity and valued roles. Theoretically, a biopsychosocial approach makes rehabilitation more meaningful, however, the limited research on meaningful rehabilitation predominantly describes the perspective of therapists and researchers. The client's perspective of meaningfulness in rehabilitation is lacking.
To investigate the experience of meaningfulness in rehabilitation from the perspective of people with chronic pain.
Qualitative, semi-structured interviews were conducted with Australian adults who had chronic pain and recent experience of occupational therapy or physiotherapy. Sampling continued until thematic saturation occurred. Transcripts were coded and analyzed using theory-driven and data-driven thematic analysis.
Ten participants (four males; six females) were interviewed. Pain histories ranged from nine months to 20+ years, with conditions such as fibromyalgia or trauma. Three themes from a prior concept analysis were upheld, and a further three data-driven themes emerged. Results indicate that people with chronic pain seek a "genuine connection"; from a therapist who is "credible"; and can become a "guiding partner", and they find rehabilitation meaningful when it holds "personal value"; is "self-defined"; and relevant to their sense of "self-identity".
The genuine connection and guiding partnership with a credible therapist, that is sought by people with chronic pain, may be at odds with aspects of contemporary rehabilitation. Client-defined meaningfulness is an important construct to engage clients in treatment and improve work and other occupational outcomes for people with chronic pain.
慢性疼痛患者可能会寻求康复治疗,以减轻疼痛并恢复生产力和有价值的角色。从理论上讲,生物心理社会方法使康复治疗更有意义,然而,关于有意义的康复治疗的有限研究主要描述了治疗师和研究人员的观点。缺乏客户对康复治疗意义的看法。
从慢性疼痛患者的角度调查康复治疗的意义体验。
对澳大利亚患有慢性疼痛且最近接受过职业治疗或物理治疗的成年人进行了定性、半结构化访谈。继续进行抽样,直到主题达到饱和。使用理论驱动和数据驱动的主题分析对转录本进行编码和分析。
对 10 名参与者(4 名男性;6 名女性)进行了访谈。疼痛病史从九个月到 20 多年不等,伴有纤维肌痛或创伤等疾病。从先前的概念分析中确定了三个主题,并且还出现了另外三个数据驱动的主题。结果表明,慢性疼痛患者寻求“真诚的联系”;来自一个“可信”的治疗师;并能成为“指导伙伴”,当康复治疗具有“个人价值”时,他们会发现它是有意义的;是“自我定义”;并且与他们的“自我认同”感相关。
慢性疼痛患者所寻求的与可信治疗师建立真诚的联系和指导伙伴关系,可能与当代康复治疗的某些方面不一致。客户定义的意义是一个重要的概念,可以让客户参与治疗,并改善慢性疼痛患者的工作和其他职业结果。