An expanded view of self-management: patients' perceptions of education and support in an intervention for chronic musculoskeletal pain
Pain Medicine, 07/11/2012
Matthias MS et al. – Results corroborate previous work and suggest that current conceptualizations of self–management are incomplete. A model is proposed that not only depicts self–management as involving more than activities and strategies, but also acknowledges the central role of relationships and support in pain self–management.Methods
- Qualitative interviews were conducted with 26 patients in the intervention arm of ESCAPE (21% of total intervention patients) to determine patients' experiences with and perceptions of the intervention.
- Patients were purposefully sampled to include treatment responders (defined as ≥30% reduction in pain–related disability or pain severity), nonresponders, and noncompleters (completed <50% of trial).
- Qualitative analysis was guided by grounded theory.
- Both responders and nonresponders discussed the importance of the self–management education they received.
- Of particular significance, patients identified the nurse care manager who administered the intervention as being integral to patients' ability to self–manage their chronic pain.
- Patients described important ways in which the nurse facilitated their self–management, reported under three themes:
- Helping patients find what works for their pain;
- Holding patients accountable for their pain management;
- Motivating and providing emotional support to patients.