title: Being in an exchange process: experiences of patient participation in multimodal pain rehabilitation.
abstract: OBJECTIVE
  To explore primary healthcare patients' experiences of patients participation in multimodal pain rehabilitation.
  
  
  METHODS
  A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis.
  
  
  RESULTS
  One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients' emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient's personal relationships with the health professionals, forming the category Confidence-inspiring alliance. In the category Competent health professionals, the health professionals' expertise, empathy and personal qualities, were emphasized to favour patient participation.
  
  
  CONCLUSIONS
  Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient's needs in the participation process may favour patient participation.
authors.affiliation: Dept. of Health Science, Luleå University of Technology, 97187 Luleå, Sweden. Catharina.Nordin@nll.se
authors.forename: Catharina
authors.initials: C
authors.lastname: Nordin
authors.forename: Gunvor
authors.initials: G
authors.lastname: Gard
authors.forename: Anncristine
authors.initials: A
authors.lastname: Fjellman-Wiklund
mesh_terms: D000293:Adolescent; D000328:Adult; D003299:Cooperative Behavior; D004645:Empathy; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology* / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology*; D011320:Primary Health Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D035502:Trust / Q000523:psychology; D055815:Young Adult