"It has changed my picture of myself": how did females living with chronic pain perceive the impact of the standard pain rehabilitation, including the occupational therapy lifestyle intervention REVEAL(OT)?

Abstract

Purpose

This study investigated patient perceptions of multidisciplinary chronic pain rehabilitation, including the occupational therapy lifestyle management program REVEAL(OT), on everyday life with chronic pain.

Methods

Individual interviews were conducted using video conferencing after completing multidisciplinary chronic pain rehabilitation. The interviews followed a semi-structured interview guide and investigated patient experiences with occupational therapy-supported health behavior transformation. The interviews were transcribed verbatim and analyzed iteratively using an inductive semantic data-driven approach inspired by Braun & Clarke’s methodology.

Results

Five females, 34 to 58 years old, revealed three common themes: To discover oneself anew; Increased energy and calmness; and Look into the future. The themes reflected transformations towards a healthier lifestyle through enhanced self-control, developing meaningful and secure everyday activities, and gaining reaffirmed dignity. The study also identified the participants’ need for professional assistance to cope with the pain after discharge.

Conclusions

Chronic pain rehabilitation that included an occupational therapy intervention supported health behavior transformation and chronic pain self-management in females, where meaningful daily occupations and physical activity played an important role. Individually tailored support, also available after chronic pain rehabilitation, would benefit the transformation process towards improved pain coping in females.

Implications for rehabilitation

• Personal gains for health and well-being may develop over a shorter or longer time after chronic pain rehabilitation.

• Targeting daily occupations and physical activity during chronic pain rehabilitation appears meaningful for females living with chronic pain.

• Progression from an individual to group approach can be relevant in planning chronic pain rehabilitation, but the individual capacities shall be considered.

• Male perspectives on chronic pain rehabilitation that includes focus on daily occupations and lifestyle need further investigation.

Keywords:

• Chronic pain
• health behavior
• pain clinics
• pain management
• pain rehabilitation
• program evaluation

Acknowledgements

We want to thank the participants of this study for their engagement and time spent in the interviews. We also appreciate the clinicians for supporting the intervention’s conduct.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The corresponding author can provide access to additional data from this study.

Additional information

Funding

Dr Nielsen received funding for her PhD study from Region Zealand, Denmark; Naestved, Slagelse and Ringsted Hospitals’ Research Fund, Denmark (SJ-703); The University of Southern Denmark (Ph.D. scholarship for Svetlana S.Nielsen); and The Danish Occupational Therapy Association (reg. FF1-18-R76-A1690), and is currently funded by Region Zealand (Exercise First program). JRC is associate editor of the journal Frontiers in Occupational therapy and an academic editor of the Journal of Obesity and has received personal fees from Munksgaard and Gyldendal, both of which are outside the submitted work. She is the founder of the Danish Obesity Intervention Trial (DO:IT), a not-for profit initiative hosted at the University of Southern Denmark aiming at implementing clinical guidelines for persons with obesity in clinical practice. JS has participated in scientific advisory boards for Novo Nordic, Roche, Astra-Zeneca, GlaxoSmith Kline Pharma, he is editor for Promedicin.dk and holds grants from EU, the Danish Research council and numerous other funds. STS is associate editor of the Journal of Orthopaedic & Sports Physical Therapy and has received personal fees from Munksgaard and TrustMe-Ed, both of which are outside the submitted work. He is co-founder of Good Life with Osteoarthritis in Denmark (GLA:D®), a not-for profit initiative hosted at the University of Southern Denmark aiming at implementing clinical guidelines for persons with osteoarthritis in clinical practice. Dr Skou is currently funded by Region Zealand (Exercise First program) and two grants within the European Union’s Horizon 2020 research and innovation program (MOBILIZE, grant agreement No 801790, of the European Research Council; and ESCAPE, grant agreement No 945377). This work was also supported by European Union’s Horizon 2020 research and innovation program, the European Research Council.