title: Experienced dilemmas of everyday life in chronic neuropathic pain patients--results from a critical incident study.
abstract: Neuropathic pain is a disabling chronic condition with limited therapeutic options. Few studies have addressed patient's experience and strategies. The aim of this study was to explore dilemmas experienced in order to improve care and rehabilitation. An interview study with 39 patients suffering from neuropathic pain of different origin was performed. We used the critical incident technique to collect data. Questions on occasions when patients had been hindered by or reminded of their neuropathic pain were included, and the self-perceived consequences and management of such occasions. The interviews were transcribed verbatim and analysed qualitatively. A broad range of experiences categorised into dilemmas, disturbances, consequences and managements from most parts of everyday life was identified. The dilemmas were 'housework', 'sitting', 'physical activity', 'personal hygiene', 'sleeping difficulties', 'hypersensitivity to external stimuli', 'social relationships', 'transportation' and 'leisure time'. Disturbances were 'failures', 'inabilities' and 'restrictions'. Consequences were 'increased pain', 'psychological reactions' and 'physical symptoms'. The majority of the patients used activity-oriented strategies to manage their pain such as alternative ways of performing the task, a cognitive approach or simply ignoring the pain. This is one of the first studies presenting detailed data on everyday dilemmas, disturbances and consequences of patients with chronic neuropathic pain. Such information is important in clinical settings to improve care and rehabilitation.
authors.affiliation: Social Medicine, Department of Community Medicine and Public Health, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. gunnel.hensing@socmed.gu.se
authors.forename: Gunnel K E
authors.initials: GK
authors.lastname: Hensing
authors.forename: Annette M
authors.initials: AM
authors.lastname: Sverker
authors.forename: Göran S
authors.initials: GS
authors.lastname: Leijon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology* / Q000523:psychology*; D013647:Task Performance and Analysis