Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management
Lauren S Penney,1,2 Elizabeth Haro1,2 1South Texas Veterans Health Care System, San Antonio, TX 78229, USA; 2Department of Medicine, The University of Texas Health at San Antonio, San Antonio, TX 78229, USA Background: Many leaders in the field of chronic pain treatment co...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-03-01
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| Series: | Journal of Pain Research |
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| Online Access: | https://www.dovepress.com/qualitative-evaluation-of-an-interdisciplinary-chronic-pain-interventi-peer-reviewed-article-JPR |
| _version_ | 1818262513955897344 |
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| author | Penney LS Haro E |
| author_facet | Penney LS Haro E |
| author_sort | Penney LS |
| collection | DOAJ |
| description | Lauren S Penney,1,2 Elizabeth Haro1,2 1South Texas Veterans Health Care System, San Antonio, TX 78229, USA; 2Department of Medicine, The University of Texas Health at San Antonio, San Antonio, TX 78229, USA Background: Many leaders in the field of chronic pain treatment consider interdisciplinary pain management programs to be the most effective treatments available for chronic pain. As programs are instituted and expanded to address demands for nonpharmacological chronic pain interventions, we need to better understand how patients experience program impacts, as well as the challenges and supports patients encounter in trying to maintain and build on intervention gains. Methods: We conducted a qualitative evaluation of an interdisciplinary chronic pain coaching program at the Atlanta Veterans Affairs. A purposive sample of Veterans were engaged in interviews (n=41) and focus groups (n=20) to elicit patient outcomes and barriers and facilitators to sustainment of improvements. Transcripts were analyzed using matrix and thematic analyses. Results: Veterans reported various outcomes. Most frequently they described adopting new self-care or lifestyle practices for pain management and health. They also often described accepting pain, being better able to adjust and set boundaries, feeling more in control, participating in life, and changing their medication use. A small portion of the sample reported no improvement in their conditions. When outcomes were examined as a whole, individuals described impacts that could be placed along a spectrum from whole life change to no change. Facilitators to maintenance of improvements included having building blocks (eg, carrying forward practices learned), support (eg, access to resources), and energy (eg, motivation), and improving incrementally. Challenges were not having building blocks (eg, life disruptions), support (eg, unknown follow-up options), and energy (eg, competing demands) and having an unbalanced rate of improvement. Conclusion: Most Veterans identified experiencing multiple areas of improvement, especially learning about and taking up new pain and general health management skills. Ensuring participants can build on and find support for these outcomes when applying what they have learned in their dynamic social and physical worlds remains a challenge for this program and other relatively short-term interdisciplinary chronic pain interventions. Keywords: chronic pain, multimodal treatment, interviews, quality improvement |
| first_indexed | 2024-12-12T19:04:20Z |
| format | Article |
| id | doaj.art-cf39eaab1f0044588fb88e86694b724d |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-12T19:04:20Z |
| publishDate | 2019-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-cf39eaab1f0044588fb88e86694b724d2022-12-22T00:14:59ZengDove Medical PressJournal of Pain Research1178-70902019-03-01Volume 1286587844412Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain managementPenney LSHaro ELauren S Penney,1,2 Elizabeth Haro1,2 1South Texas Veterans Health Care System, San Antonio, TX 78229, USA; 2Department of Medicine, The University of Texas Health at San Antonio, San Antonio, TX 78229, USA Background: Many leaders in the field of chronic pain treatment consider interdisciplinary pain management programs to be the most effective treatments available for chronic pain. As programs are instituted and expanded to address demands for nonpharmacological chronic pain interventions, we need to better understand how patients experience program impacts, as well as the challenges and supports patients encounter in trying to maintain and build on intervention gains. Methods: We conducted a qualitative evaluation of an interdisciplinary chronic pain coaching program at the Atlanta Veterans Affairs. A purposive sample of Veterans were engaged in interviews (n=41) and focus groups (n=20) to elicit patient outcomes and barriers and facilitators to sustainment of improvements. Transcripts were analyzed using matrix and thematic analyses. Results: Veterans reported various outcomes. Most frequently they described adopting new self-care or lifestyle practices for pain management and health. They also often described accepting pain, being better able to adjust and set boundaries, feeling more in control, participating in life, and changing their medication use. A small portion of the sample reported no improvement in their conditions. When outcomes were examined as a whole, individuals described impacts that could be placed along a spectrum from whole life change to no change. Facilitators to maintenance of improvements included having building blocks (eg, carrying forward practices learned), support (eg, access to resources), and energy (eg, motivation), and improving incrementally. Challenges were not having building blocks (eg, life disruptions), support (eg, unknown follow-up options), and energy (eg, competing demands) and having an unbalanced rate of improvement. Conclusion: Most Veterans identified experiencing multiple areas of improvement, especially learning about and taking up new pain and general health management skills. Ensuring participants can build on and find support for these outcomes when applying what they have learned in their dynamic social and physical worlds remains a challenge for this program and other relatively short-term interdisciplinary chronic pain interventions. Keywords: chronic pain, multimodal treatment, interviews, quality improvementhttps://www.dovepress.com/qualitative-evaluation-of-an-interdisciplinary-chronic-pain-interventi-peer-reviewed-article-JPRchronic paininterdisciplinary pain programqualitativeVeterans |
| spellingShingle | Penney LS Haro E Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management Journal of Pain Research chronic pain interdisciplinary pain program qualitative Veterans |
| title | Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management |
| title_full | Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management |
| title_fullStr | Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management |
| title_full_unstemmed | Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management |
| title_short | Qualitative evaluation of an interdisciplinary chronic pain intervention: outcomes and barriers and facilitators to ongoing pain management |
| title_sort | qualitative evaluation of an interdisciplinary chronic pain intervention outcomes and barriers and facilitators to ongoing pain management |
| topic | chronic pain interdisciplinary pain program qualitative Veterans |
| url | https://www.dovepress.com/qualitative-evaluation-of-an-interdisciplinary-chronic-pain-interventi-peer-reviewed-article-JPR |
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