Tidmarsh Lydia V, Harrison Richard, Wilkinson Harriet, Harrington Megan, Finlay Katherine A
School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, UK.
Br J Pain. 2025 Jan 6:20494637241311456. doi: 10.1177/20494637241311456.
Waitlists for pain management services are often extensive, risking psychological and physical decline and patient non-engagement in treatment once accessed. Currently, for outpatient pain management, no standardised waiting list interventions exist, resulting in passive waiting. To arrest prospective wait-related decline(s), this study aimed to identify the barriers and facilitators to pain self-management while waiting, forming the foundation for a waitlist intervention development.
An inductive qualitative approach was utilised to explore the barriers and drivers of pain self-management while waiting for chronic pain management.
Semi-structured interviews, underpinned by the Theoretical Domains Framework and COM-B model, were conducted with people waiting for pain management services ( = 38). Interviews were audio-recorded, transcribed verbatim, and analysed via reflexive thematic analysis.
The analysis demonstrated four thematised barriers and one facilitator: (1) Shunted Around the System ; (2) The Information Gap ; (3) Resisting Adaptation (); (4) Losing Hope ( and (5) Help Yourself or Lose Yourself .
This study demonstrates the severe emotional and motivational impact of waiting, increasing treatment disengagement. The waitlist represents a prime opportunity for prehabilitation to protect wellbeing and optimise self-management engagement. Infrastructural and interpersonal barriers of poor communication and healthcare professional pain invalidation must be addressed to improve emotional wellbeing and motivation to engage with planned treatment. Enhancing self-efficacy, pain acceptance, self-compassion, and internal HLOC are fundamental to increasing pain self-management. These can all be met within a prehabilitation framework. This study is foundational for the development of psychological prehabilitation in outpatient chronic pain management.
疼痛管理服务的等候名单往往很长，这有导致患者心理和身体状况恶化以及在获得治疗后不参与治疗的风险。目前，对于门诊疼痛管理，不存在标准化的等候名单干预措施，导致患者只能被动等待。为了阻止未来与等候相关的状况恶化，本研究旨在确定等待期间疼痛自我管理的障碍和促进因素，为开发等候名单干预措施奠定基础。
采用归纳定性方法，探索等待慢性疼痛管理期间疼痛自我管理的障碍和驱动因素。
以理论领域框架和COM-B模型为基础，对等候疼痛管理服务的人员（n = 38）进行了半结构化访谈。访谈进行了录音，逐字转录，并通过反思性主题分析进行分析。
分析显示了四个主题化的障碍和一个促进因素：（1）在系统中四处碰壁；（2）信息鸿沟；（3）抗拒适应；（4）失去希望；（5）自助或自弃。
本研究表明等待会产生严重的情绪和动机影响，增加治疗不参与度。等候名单是进行预康复以保护健康和优化自我管理参与度的绝佳机会。必须解决沟通不畅和医疗保健专业人员对疼痛不予认可等基础设施和人际方面的障碍，以改善情绪健康和参与计划治疗的动机。提高自我效能感、疼痛接纳度、自我同情和内在的掌控感 locus of control，对增强疼痛自我管理至关重要。这些都可以在预康复框架内实现。本研究是门诊慢性疼痛管理中心理预康复发展的基础。
