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Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry

机译：低收入患者的慢性疼痛自我管理计划：来自定性查询的主题

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摘要

Objective. To examine factors influencing initial engagement, ongoing participation, learned behaviors, and subjective functional outcomes after a trial of the Living Better Beyond Pain (LBBP) chronic pain self-management program. Design. Qualitative study using the Grounded Theory approach. Setting. Two 60-minute focus groups and phone interviews in May 2017. Subjects. Focus groups with 18 participants who completed LBBP and six-month measures; telephone interviews with 17 participants who stopped attending. Methods. Study coordinators randomly selected program completers for focus groups and conducted phone interviews with noncompleters. Inductive thematic analysis was used to identify patterns in semantic content with a recursive process applied to focus group transcripts and interview transcriptions to codify into themes. Themes were categorized according to the Theory of Planned Behavior. Results. Focus group and telephone interview participants were primarily Hispanic and unemployed. Attitudes fostering participation in LBBP included dissatisfaction with the status quo, need to reduce pain medication, and lack of training and knowledge about chronic pain. Positive social norms from meeting others with chronic pain and support from the LBBP team encouraged attendance and adoption of behaviors. Transportation, pain, and competing activities were barriers, whereas adapting activities for the disabled was a facilitator. Maintaining behaviors and activities at home was challenging but ultimately rewarding due to improvement in daily function with less pain medication. Conclusions. This qualitative study complements quantitative results showing clinically significant improvements in function after the LBBP program by adding practical insights into ways to increase participation and outcomes. Participants strongly endorsed the need for chronic pain self-management training.
机译：客观的。检查影响初始参与，持续参与，学习行为和主观功能成果的因素，在痛苦（LBBP）慢性疼痛自我管理方案中更好地进行患者。设计。使用基础理论方法的定性研究。环境。 2017年5月，两名60分钟的重点小组和电话采访。主题。焦点小组与18名参与者完成LBBP和六个月的措施;与17名参与者停止参加的电话采访。方法。学习协调员随机选择了焦点小组的程序完成者，并进行了非比量计的电话访谈。归纳专题分析用于识别语义含量的模式，递归过程应用于对焦组转录物和面试转录，以编纂主题。主题是根据计划行为理论进行分类的。结果。焦点小组和电话采访参与者主要是西班牙裔和失业者。培养参与LBBP的态度包括对现状的不满，需要减少疼痛药物，以及缺乏关于慢性疼痛的培训和知识。积极的社会规范从慢性痛苦与慢性痛苦和支持的支持，鼓励行为的出席和采用。运输，痛苦和竞争活动是障碍，而适应残疾人的活动是一个促进者。维持家庭的行为和活动是挑战，但最终因日常功能的改善而最终得到奖励，较少疼痛药物。结论。这种定性研究补充了定量结果，通过向增加参与和结果的方式增加了LBBP计划之后的临床上显着改善。参与者非常批准了对慢性疼痛自我管理培训的需求。

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