title: Change Narratives That Elude Quantification: A Mixed-Methods Analysis of How People with Chronic Pain Perceive Pain Rehabilitation.
abstract: Chronic pain negatively impacts health, well-being, and social participation. Effective rehabilitation often hinges on long-term changes in pain-related perceptions and behaviors. However, there are important gaps in understanding how patients perceive these changes. The present pilot study addresses this gap by using qualitative and quantitative methodologies to explore how patients perceive and experience changes in function, participation, and pain-related factors following a chronic pain rehabilitation program. A mixed-method design was used in which the core method was qualitative. Descriptive quantitative data was used to further characterize the sample. Semistructured interviews were conducted 1-6 months following treatment completion. Questionnaires were administered before and after treatment and at follow-up. Interview data was analyzed thematically. Participants' individual descriptive data was compared to established cut-scores and criteria for change. A major theme of personal growth emerged in the qualitative analysis. Participants also discussed the factors that facilitated personal growth and the ongoing challenges to this growth. The quantitative data revealed limited improvement on measures of pain, disability, catastrophizing, and depression. These findings suggest that, despite limited improvement on treatment-related questionnaires, patients can experience an important and enduring sense of personal growth. Clinical and theoretical implications are discussed.
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
authors.forename: Timothy H
authors.identifier: 0000-0003-1574-6967
authors.initials: TH
authors.lastname: Wideman
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Alice
authors.initials: A
authors.lastname: Boom
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dell'Elce
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Bergeron
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Janick
authors.initials: J
authors.lastname: Fugère
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Xiangying
authors.initials: X
authors.lastname: Lu
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Geoff
authors.initials: G
authors.lastname: Bostick
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: Heather C
authors.initials: HC
authors.lastname: Lambert
mesh_terms: D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062525:Narrative Therapy / Q000379:methods; D059408:Pain Management / Q000379:methods / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D058748:Pain Perception; D010865:Pilot Projects; D057566:Self Report