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|Title:||Living and doing with chronic pain: clients' and occupational therapists' perspectives|
|Authors:||van Huet, Helen|
|Keywords:||chronic pain management|
clients' and occupational therapists' perspectives
|Publisher:||University of Sydney.|
Faculty of Health Sciences, Discipline of Occupational Therapy
|Abstract:||The purpose of this research was to investigate how people with chronic pain manage their pain in the long term and what factors influence that management. The perspectives of past participants of a chronic pain management program (PMP) and occupational therapists working with people with chronic pain were sought to see if there was compatibility or difference in their points of view. The overarching research questions that arose from a review of the literature were: • What factors predict successful pain management in the long term? • How do people live and do with chronic pain in their everyday lives? These questions formed the foundation for further detailed exploration of how social factors, personal beliefs and meanings, individual attributes and strategies influenced pain management. The study design was based on qualitative methods, in this instance narrative inquiry, to gain stories from PMP participants of living with pain and therapist-participants of working in pain practice. Narrative inquiry was selected as it allowed participants to tell their stories of living and working with chronic pain. Stories inherently contain aspects of the past, present and future. This was an important element to capture in relation to the time contingent process of chronic pain management (Charmaz, 1991). Fifteen PMP participants were recruited in Stage 1 of the research, both males and females, with ages ranging from 31 to 64 years. Nine therapist-participants were recruited in Stage 2, who worked across a range of chronic pain settings including private practice, community-based and hospital-based pain programs. Data were gathered through semi-structured interviews predominantly conducted at PMP participants’ homes and therapist-participants’ places of work. Interviews were tape-recorded and transcribed verbatim, with all participants receiving a summary of interviews for comment. Data analysis used an iterative and interpretive approach. Transcripts were read as whole stories, with initial researcher impressions noted and recorded. Transcripts were then subjected to closer scrutiny, with key themes, words and phrases noted using the participants’ language. These detailed themes were sorted into common groupings and compared across participants. Idiosyncratic themes were not discarded. The main themes that emerged related to the categories of self/identity, meaning ascriptions about pain, strategies used, and the influence of the social world. Within each of these categories, factors became apparent that influenced whether a person was predominantly agentic, active in their pain self-management, or victimic and passive, relying on external support (Polkinghorne, 1995). A conceptual model is proposed based on (a) knowing (meanings ascribed to chronic pain), (b) doing (strategies and methods used to engage in everyday activities), and (c) being (aspects of the self intrinsically and socially constructed) as critical to managing chronic pain. These factors are significant when considering how people live with chronic pain within the community in the long term and also how and when health care services specific to chronic pain might best be utilised to achieve favourable outcomes.|
|Description:||Doctor of Philosophy (PhD)|
|Rights and Permissions:||The author retains copyright of this thesis.|
|Type of Work:||PhD Doctorate|
|Appears in Collections:||Sydney Digital Theses (Open Access)|
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