Acceptance and Change in a Rheumatology Pain Management Programme: an Interpretative Phenomenological Analysis of Patients’ Reflections.

Abstract

Quantitative evidence supports the effectiveness of acceptance based cognitive behavioural therapies (CBT) for chronic pain. Qualitative research has explored the experiences of chronic pain sufferers. However, there is an absence of literature examining the processes through which improvements are made. This study sought to qualitatively analyse the experiences of 6 adult patients who completed an acceptance based CBT pain management programme (PMP). Semi-structured interviews were carried out and verbatim transcripts were subjected to Interpretative Phenomenological Analysis. Three superordinate themes were identified: acceptance of a renewed sense of self; feelings of insecurity in the context of healthcare; and sustained motivation for change. These results add to the evidence base regarding a loss of sense of self. However, in addition, a renewed sense of self was found amongst patients’ reports of their subjective experiences of participation in the PMP. The findings also highlight the processes by which the renewed sense of self was reached and these are discussed in relation to chronic pain literature. Potential areas for improvement in clinical practice are identified.