title: Care related pain in rehabilitation after orthopedic trauma: An exploratory study with qualitative data.
abstract: OBJECTIVE
  Care related pain (CRP) is generally under-estimated and rarely studied in rehabilitation as well as in general medecine. Beliefs about pain influence psychological distress, adjustment to pain and physical disability. In this sense, perceptions of CRP could limit recovery. This exploratory study aims to understand patients' and caregivers' subjective perceptions and beliefs about CRP.
  
  
  METHODS
  Questionnaires about CRP were submitted to members of the interdisciplinary team of a rehabilitation hospital and to patients with musculoskeletal complaints (cross-sectional design). Twenty patients were also individually interviewed (qualitative data). Four topics were addressed: frequency of CRP, situations and procedures causing CRP, beliefs about CRP and means used to deal with CRP.
  
  
  RESULTS
  Seventy-five caregivers and 50 patients replied to the questionnaire. CRP is a very common experience in rehabilitation and it is recognized by both groups. Generally, the situations causing CRP reflect the specificity of rehabilitation (mobilization…) and are similarly perceived by patients and caregivers, with patients considering them as more painful. Beliefs about CRP are clearly different from those usually associated with pain. Both groups point out the utilitarian and the inevitable character of CRP. They differ on that, that patients had a more positive view about CRP. They associate it more often with progress and see it as acceptable at least until a certain limit. They are also able to perceive the richness of means used by physiotherapists to help them coping with CRP.
  
  
  CONCLUSIONS
  Our data may suggest new keys to motivate patient to be active in rehabilitation for example in choosing carefully arguments or words which may fit theirs' beliefs about CRP, or in using various means to manage CRP. Promoting the use of relational competences with chronic pain patients and of a patient-centred approach may also be a concern in training caregivers.
authors.affiliation: Service de psychosomatique, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland. Electronic address: christine.favre@crr-suva.ch.
authors.forename: C
authors.initials: C
authors.lastname: Favre
authors.affiliation: Institut de recherche en réadaptation-réinsertion, avenue Grand-Champsec 90, 1950 Sion, Switzerland.
authors.forename: O
authors.initials: O
authors.lastname: Dériaz
authors.affiliation: Service de physiothérapie, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Hanon
authors.affiliation: Service de réadaptation de l'appareil locomoteur, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland; Département de l'appareil locomoteur, service de rhumatologie, centre hospitalier universitaire Vaudois (CHUV), avenue Pierre-Decker 4, 1005 Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Luthi
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D058748:Pain Perception; D026741:Physical Therapy Modalities / Q000009:adverse effects / Q000523:psychology*; D036301:Qualitative Research; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology / Q000534:rehabilitation
keywords: Belief; Care related pain; Cross-sectional study; Physical therapy; Trauma