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Living With Chronic Pain After Spinal Cord Injury: A Mixed-Methods Study.

Abstract：

OBJECTIVE:To identify the relative importance of positive (facilitators) and negative (barriers) contributors to living with chronic pain after spinal cord injury (SCI). DESIGN:Mixed-methods: (1) Qualitative (n=35): individual, semistructured, open-ended interviews identifying facilitator/barrier themes; (2) Quantitative (n=491): converting the most common themes into statements and quantifying agreement with these in an online survey to determine relative importance, underlying dimensions, and their associations with perceived difficulty in dealing with pain. SETTING:University-based research setting and general community. PARTICIPANTS:Volunteers (N=526) with SCI experiencing moderate to severe chronic pain. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Interview guides, facilitator/barrier statements, and pain inventories. RESULTS:Exploratory factor analyses reduced agreement ratings into 4 facilitators (information regarding pain and treatments, resilience, coping, medication use) and 5 barriers (poor health care communication, pain impact and limitations, poor communication about pain, difficult nature of pain, treatment concerns). Greater "pain impact and limitations," "difficult nature of pain," "poor communication from provider," lower "resilience," greater "medication use," and younger age predicted greater difficulty in dealing with pain (r=.75; F=69.02; P<.001). CONCLUSIONS:This study revealed multiple facilitators and barriers to living with chronic pain after SCI. The principal barrier, "poor health care communication," indicated that consumers do not receive adequate information from their health care providers regarding pain. "Information regarding pain and treatments" had greater agreement scores and factor loadings than all other facilitators, indicating that most participants view provider-patient communication and educational efforts regarding pain and pain management as priorities and critical needs. Further initiatives in these areas are important for improving pain management post-SCI.

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

Widerström-Noga E,Anderson KD,Perez S,Hunter JP,Martinez-Arizala A,Adcock JP,Escalona M

doi

10.1016/j.apmr.2016.10.018

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

856-865

issue

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(16)31284-9

journal_volume

pub_type

杂志文章

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Living With Chronic Pain After Spinal Cord Injury: A Mixed-Methods Study.