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

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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HRV Biofeedback and Addiction: Rehabbing Body, Mind and Spirit

Biofeedback ◽

10.5298/1081-5937-49.01.02 ◽

2021 ◽

Vol 49 (1) ◽

pp. 10-17

Author(s):

Amy Hudson

Keyword(s):

Heart Rate ◽

Chronic Pain ◽

Heart Rate Variability ◽

The Body ◽

Heart Rate Variability Biofeedback ◽

The Mind

Addiction is a devastating disease of the body, the mind, and even the personality. Recent research shows that heart rate variability biofeedback can help the alcoholic/addict recover in three crucial ways, namely (1) treating the associated comorbidities (depression, anxiety, chronic pain), (2) treating the physiology around craving, and (3) returning to a loving and nurturing relationship with one's own body instead of an abusive and exploitive one.

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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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The stakeholders' perspective on the factors contributing to construction disputes

International Journal of Building Pathology and Adaptation ◽

10.1108/ijbpa-06-2020-0050 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Pinar Irlayici Cakmak

Keyword(s):

Construction Industry ◽

Construction Projects ◽

Subject Area ◽

Qualitative Approach ◽

The Body ◽

Depth Information ◽

Structured Interviews ◽

Content Type ◽

Construction Disputes ◽

Qualitative Exploration

PurposeWhile a considerable amount of research has been conducted on construction disputes, disputes remain prevalent in the construction industry and have still been a crucial problem in the Turkish construction industry as well. The purpose of this paper is to explore the perceptions of different stakeholders on key factors that contribute to construction disputes by adopting a qualitative approach.Design/methodology/approachThe qualitative approach adopted for the study provided gathering in-depth and rich information about the topic. To explore the phenomenon in-depth information, semi-structured interviews were conducted. A total of 38 interviews were conducted among experts and practitioners who engaged in construction disputes.FindingsContent analysis of interview data resulted in the emergence of varying categories relevant to the problems which result in construction disputes. By grouping related themes into main categories, the analysis yielded five major ones: clarity of the contract form, errors in contract documents, payments, changes, delays and not granting extension of time.Research limitations/implicationsThe major limitations are having interviewees from one country and results limited to the Turkish construction industry.Practical implicationsThe findings provide insight on the factors contributing to construction disputes as perceived by different stakeholders, which should provide guidance to determine the associated risks for dispute occurrence, make effort to mitigate disputes once they happen, take proper precautions for minimizing the effects and after all make a significant contribution in the successful accomplishment of completed construction projects.Originality/valueThe findings of the study contribute to a deeper understanding of the factors contributing to construction disputes through a qualitative approach which is limited in the related literature. Although the qualitative exploration only focuses on the Turkish construction industry, the study has added significantly to the body of knowledge within the subject area.

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Illustrations of the Influence of the Mind upon the Body in Health and Disease, with especial Reference to the Imagination

Journal of Mental Science ◽

10.1192/bjp.18.81.8 ◽

1872 ◽

Vol 18 (81) ◽

pp. 8-31

Author(s):

Daniel H. Tuke

Keyword(s):

Blood Vessels ◽

Fundamental Principle ◽

The Body ◽

Especial Reference ◽

Emotional Excitement ◽

Health And Disease ◽

Motor Nerves ◽

The Mind ◽

Circulation Of The Blood

We have in the consideration of the influence of the emo tions upon the blood-vessels anticipated, to some extent, the fundamental principle of this section. The important part played by the vaso-motor nerves was there dwelt upon, chiefly in connection with the vascularity of the skin, which so manifestly results from emotional excitement. The circulation of the blood through the various organs of the body being affected by the same cause, the action of the emotions in inducing well-marked changes in nutrition and secretion is not extraordinary. But the question which at once arises, whether these variations in the circulation of the blood in the organs and tissues, adequately account for the alterations in nutrition and secretion, now referred to, deserves some consideration here.

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A qualitative exploration of perspectives of physical activity and sedentary behaviour among Indian migrants in Melbourne, Australia: how are they defined and what can we learn?

BMC Public Health ◽

10.1186/s12889-021-12099-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Siona Fernandes ◽

Cristina M. Caperchione ◽

Lukar E. Thornton ◽

Anna Timperio

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Cultural Background ◽

Outdoor Environment ◽

Structured Interviews ◽

Migrant Populations ◽

Social Caste ◽

And Migration ◽

The Mind ◽

Qualitative Exploration

Abstract Background Although perceptions of what constitutes physical activity (PA) may vary between culturally diverse populations, very little research has explored the perceptions of PA among Indian migrants. This study aimed to identify how PA and sedentary behaviour (SB) are defined and describe how these definitions are shaped by cultural background and migration among a sample of Indian migrants living in Australia. Methods Using an exploratory qualitative approach, semi-structured interviews were conducted with twenty-one Indian migrants living in Melbourne (10 men and 11 women; age range: 18 to 65 years). Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed inductively using thematic analyses. Results Data revealed two emerging themes: 1) Holistic perspectives related to PA, where although the majority of participants described PA as “any sort of movement”, or “physical exercise”, several of these descriptions had interwoven ideas related to the mind (mind-body connect), social, cultural, and to the outdoor environment; 2) Broader perspectives for SB, where descriptions of SB as “not having movement”, “doing nothing” or “being lazy”, were shaped with ideas of purpose and duration. Women spoke about how their perspectives of PA and SB may be shaped by native Indian experiences, particularly the gender roles, social caste, and regional subcultural norms which they perceived were important to consider among women who migrate to western settings. Conclusions Cultural background is important in shaping the perspectives of PA and SB among Indian migrants in Australia. Practitioners and researchers should consider the varying perspectives of PA to communicate and promote PA among migrant populations more effectively.

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Burnout of the Mind – Burnout of the Body?

Journal of Psychophysiology ◽

10.1027/0269-8803/a000182 ◽

2018 ◽

Vol 32 (1) ◽

pp. 30-42 ◽

Cited By ~ 2

Author(s):

Claudia Traunmüller ◽

Kerstin Gaisbachgrabner ◽

Helmut Karl Lackner ◽

Andreas R. Schwerdtfeger

Keyword(s):

Blood Pressure ◽

Allostatic Load ◽

Maslach Burnout Inventory ◽

The Body ◽

Lower Percentage ◽

Control Group ◽

Urinary Catecholamines ◽

Morning Cortisol ◽

The Mind ◽

Cortisol Increase

Abstract. In the present paper we investigate whether patients with a clinical diagnosis of burnout show physiological signs of burden across multiple physiological systems referred to as allostatic load (AL). Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were assessed. We examined patients who had been diagnosed with burnout by their physicians (n = 32) and were also identified as burnout patients based on their score in the Maslach Burnout Inventory-General Survey (MBI-GS) and compared them with a nonclinical control group (n = 19) with regard to indicators of allostatic load (i.e., ambulatory ECG, nocturnal urinary catecholamines, salivary morning cortisol secretion, blood pressure, and waist-to-hip ratio [WHR]). Contrary to expectations, a higher AL index suggesting elevated load in several of the parameters of the HPA and SAM axes was found in the control group but not in the burnout group. The control group showed higher norepinephrine values, higher blood pressure, higher WHR, higher sympathovagal balance, and lower percentage of cortisol increase within the first hour after awakening as compared to the patient group. Burnout was not associated with AL. Results seem to indicate a discrepancy between self-reported burnout symptoms and psychobiological load.

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