title: Reflecting the transition from pain management services to chronic pain support group attendance: An interpretative phenomenological analysis.
abstract: Transitioning from clinical care to community-based self-management represents a significant challenge, throughout which social support can facilitate health adjustment and quality of life. However, community-centred, peer-led support structures are often underused. This study aimed to investigate the decision-making processes involved in the choice to attend a chronic pain support group (CPSG) following discharge from a Pain Management Programme.
  
  
  
  An in-depth, qualitative analysis was undertaken using interpretative phenomenological analysis, exploring participants' subjective experiences, decision-making, and rationale for initial CPSG attendance.
  
  
  
  Twelve participants (four males, eight females) were recruited from a regional CPSG and completed semi-structured interviews lasting between 45 and 120 min. Interviews were transcribed verbatim and analysed idiographically before a cross-case analysis was completed.
  
  
  
  Analysis of transcripts resulted in three superordinate themes: (1) The thirst for comparative friendship; (2) conjecture and the imminent choice; (3) progressive pain management. These themes reflect a desire for empathic, socially comparative friendships and the search for a forum in which to enhance pain self-management strategies, yet also internal conflict over initial CPSG attendance.
  
  
  
  Social support and associated friendships are attractive to prospective CPSG members and are conceptualized as opportunities to engage in social comparison and nurture self-care. The first visit to the support group presents a significant hurdle, but can be facilitated by managing the transition between therapeutic care and CPSG attendance. Clinicians can challenge preconceptions, foster positive viewpoints regarding the group and support collective decision-making to attend. Following initial attendance, psychosocial well-being was enhanced. Statement of contribution What is already known on this subject? Social support functions as a protective buffer against declining health. Joining a peer-led support group can be initially intimidating and the first visit presents a significant hurdle. What does this study add? Participants are predominantly attracted to support groups due to the opportunity to develop new friendships. Health-related peer groups function as fora for social comparison, enhancing self-esteem and self-efficacy. Experience of pain management programmes primes willingness to attend support groups. The initial decision to attend is difficult but facilitated by collective, group decision-making processes. Health care professionals dynamically prime the transition towards peer support structures.
authors.affiliation: Department of Psychology, School of Science and Postgraduate Medicine, University of Buckingham, UK.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Finlay
authors.affiliation: Centre for Psychological Research, University of Derby, UK.
authors.forename: James
authors.initials: J
authors.lastname: Elander
mesh_terms: D000368:Aged; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D033062:Friends / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012648:Self Care; D012657:Self-Help Groups / Q000706:statistics & numerical data*; D012944:Social Support
keywords: Chronic pain; Self-Care; Social Support; community care; phenomenology; qualitative