Qualitative exploration of a positive writing intervention for chronic pain

Teachers are an occupational group particularly prone to suffering from burnout, a condition caused by chronic stress from work overload. Burnout is a risk factor for adverse psychological and physical health, thus it is important to test the efficacy of tools and techniques for alleviating burnout and enhancing job satisfaction. One potentially suitable technique is positive expressive writing. In the present study, we investigated the effects of a positive writing intervention on burnout, job satisfaction, anxiety, perceived stress and self-reported physical symptoms. A group of teachers and a group of non-teachers who worked full-time in other professions were randomly allocated to complete either three consecutive days of positive expressive writing, or writing about a more neutral topic, online, 20 minutes per day, for three consecutive days. State anxiety declined to a greater extent for participants in the positive writing condition compared to the neutral writing condition. Positive writing also conferred benefits on some aspects of job satisfaction, but not burnout. There were no specific benefits for teachers compared to non-teachers. The present study is the first to observe that positive expressive writing may be a useful technique for enhancing job satisfaction in full-time workers.

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The Stressful Characteristics of Pain That Drive You NUTS: A Qualitative Exploration of a Stress Model to Understand the Chronic Pain Experience

Pain Medicine ◽

10.1093/pm/pnaa370 ◽

2020 ◽

Author(s):

M Gabrielle Pagé ◽

Lise Dassieu ◽

Elise Develay ◽

Mathieu Roy ◽

Etienne Vachon-Presseau ◽

...

Keyword(s):

Chronic Pain ◽

Physiological Stress ◽

Contextual Information ◽

Functional Limitations ◽

Semistructured Interview ◽

Integrative Research ◽

Physiological Stress Response ◽

Pain Experiences ◽

Comprehensive Framework ◽

Qualitative Exploration

Abstract Objective Despite decades of research on the identification of specific characteristics of situations that trigger a physiological stress response (novelty, unpredictability, threat to the ego, and sense of low control [NUTS]), no integrative research has examined the validity of this framework applied to pain experiences. This study aimed to 1) explore the stressful characteristics of pain among individuals living with chronic pain and 2) examine whether the NUTS framework comprehensively captures the stressful nature of pain. Subjects Participants were 41 adult participants living with chronic pain. Methods Interviews in six focus groups were conducted in French using a semistructured interview guide. Participants first discussed how pain is stressful. Then, they were introduced to the NUTS framework and commented on the extent to which it captured their experience. The verbatim transcriptions of interviews were reviewed using reflexive thematic analysis. Analyses were conducted in French; quotes and themes were translated into English by a professional translator. Results The pain-NUTS framework adequately captured participants’ experiences. Multiple aspects of pain (pain intensity fluctuations, pain flare-up duration, pain quality and location, functional limitations, diagnosis and treatment) were associated with one or more stress-inducing characteristics. In addition, a second layer of meaning emerged in the context of chronic pain that provided contextual information regarding when, how, and why pain became more or less stressful. Conclusions The NUTS characteristics seem to offer a comprehensive framework to understand how pain and its context of chronicity can be a source of stress. This study provides preliminary support for the pain-NUTS framework to allow the formal integration of pain and stress research.

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Exploring how people with chronic pain understand their pain: a qualitative study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0060 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Sam Keen ◽

Martha Lomeli-Rodriguez ◽

Amanda C. de C. Williams

Keyword(s):

Chronic Pain ◽

Behavioural Change ◽

Fundamental Principle ◽

The Body ◽

Structured Interviews ◽

Meta Level ◽

Pain Outcomes ◽

Variable Success ◽

The Mind ◽

Qualitative Exploration

Abstract Objectives A fundamental principle of pain management is educating patients on their pain using current neuroscience. However, current pain neurophysiology education (PNE) interventions show variable success in improving pain outcomes, and may be difficult to integrate with existing understanding of pain. This study aimed to investigate how people with chronic pain understand their pain, using qualitative exploration of their conceptualisations of pain, and how this understanding accommodated, or resisted, the messages of PNE. Methods Twelve UK adults with chronic pain were recruited through advertisements on online pain networks. Semi-structured interviews were conducted remotely, with responses elicited using the Grid Elaboration Method (GEM) and then a PNE article. Participants’ grid elaborations and responses to PNE were analysed using thematic analysis (TA). Results Three main themes were extracted from participants' grid elaborations: communicating pain, explaining pain and living with pain. These themes incorporated varied, inconsistent sub-themes: of pain as simultaneously experiential and conceptual; in the body and in the mind; diagnosable and inexplicable; manageable and insuperable. Generalised, meta-level agreement was identified in participants' PNE responses, but with doubts about its practical value. Conclusions This study shows that people understand pain through inconsistent experiential models that may resist attempts at conceptual integration. Participants' elaborations showed diverse and dissonant conceptualisations, with experiential themes of restricted living; assault on the self; pursuit of understanding pain and abandonment of that pursuit. Responses, although unexpectedly compatible with PNE, suggested that PNE was perceived as intellectually engaging but practically inadequate. Experiential disconfirmation may be required for behavioural change inhibited by embedded fears and aversive experiences. Ethical committee number UCL REC# 17833/003.

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Individualised placement support as an employment intervention for individuals with chronic pain: a qualitative exploration of stakeholder views

BJGP Open ◽

10.3399/bjgpopen20x101036 ◽

2020 ◽

Vol 4 (3) ◽

pp. bjgpopen20X101036

Author(s):

Michelle M Holmes ◽

Sabina C Stanescu ◽

Catherine Linaker ◽

Catherine Price ◽

Nick Maguire ◽

...

Keyword(s):

Chronic Pain ◽

Structured Interviews ◽

Complex Needs ◽

Stakeholder Views ◽

Work Strategies ◽

Additional Support ◽

Future Evaluation ◽

Qualitative Exploration ◽

Job Searching

BackgroundIndividualised Placement and Support (IPS) is a tailored, client-centred employment intervention for people with chronic health conditions. It involves the integration of vocational advisers within health teams to optimise return-to-work strategies. The intervention aims to get clients into employment by complementing traditional job searching skills with placements, and one-to-one mentoring alongside a work-focused health intervention.AimTo explore the concept of IPS for individuals with chronic pain.Design & settingA multi-method qualitative study was designed to explore stakeholder views of IPS for individuals with chronic pain in southern England.MethodFourteen semi-structured interviews and three focus groups were conducted with current recipients of IPS (clients), employment support workers (ESWs), and healthcare professionals (HCPs). All data were audio-recorded, transcribed, and analysed using thematic analysis.ResultsIn total, 11 HCPs, five ESWs, and nine clients participated in the study. The analysis identified four themes. The situations of chronic pain patients were discussed, including their complex needs, multifaceted relationship with work, support from HCPs, and existing programmes that were failing to meet their needs. The intervention input was highlighted, including the recruitment procedures and role of ESWs. Programme activities and outcomes were also identified.ConclusionThis study identified the complex needs and relationship with work of individuals with chronic pain. It showed that ESWs need to understand the unpredictability of symptoms for individuals with chronic pain and that clients may need additional support before a placement. The findings highlighted several activities for future IPS interventions and potential outcomes for future evaluation.

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