Background & Aims

Chronic pain represents a major public health problem with a negative impact on the individual’s health-related quality of life (HRQOL). High-impact chronic pain (HICP) is a type of CP and is defined as persistent pain with substantial restriction of life activities on most days or every day during the past three months. Patients with HICP report worse HRQOL compared to less impacted patients with CP. Hence, HRQOL is one of the most important treatment outcomes for patients with HICP, which is measured by patient-reported Outcome Measures (PROMS). The 10-item PROMIS Global Health questionnaire (PROMIS-10) is one PROM commonly used to measure HRQOL. This study aimed to gain a deeper knowledge regarding: 1) how patients with HICP understand the construct of HRQOL, 2) how they interpret PROMIS-10, and 3) how they view important change in PROMIS-10. This is important for ensuring meaningful assessment and treatment and thus improving quality of care.

Methods

This study was a qualitative study with individual, face-to-face, semi-structured interviews of 15-20 patients with HICP. The semi-structured interviews were based on two different data collection techniques: Concept Elicitation (CE) and Cognitive Debriefing (CD). CE was used to investigate the first aim. The technique is based on open questions, which aim to investigate patients’ perspectives and understandings of a condition or a concept. CD was used to examine the second aim through the Three-Step Test-Interview (TSTI) method. CD is a structured and focused technique with direct questions concerning how patients understand items in PROMS to assure content validity and accuracy of measurement. To examine the third aim of this study, there was added a fourth step to the TSTI with questions regarding how much each item (on a categorical scale) in the questionnaire should change for it to be an important change for the patient. Subsequently, the interviews were transcribed and analyzed.

Results

Preliminary results from a pilot study with three interviews examining the study’s first aim showed that patients with HICP understand HRQOL through the following three themes: “Feeling seen and understood as a person by your social network”, “Mission in life”, and “Control over your own life”. The first theme comprised that inclusive and understanding relationships can promote HRQOL while misunderstanding and judgmental relationships can impair it. The second theme included that the patients understand HRQOL as having a mission in life, which can be both participating in collective activities and voluntary work, but also finding meaning in life’s everyday small things. The third theme showed that the patients understand HRQOL as having control over one’s life by being able to prioritize one’s energy.
Complete results from the main study’s three aims are expected at the time of the conference and will be presented.

Conclusions

Preliminary results from a pilot study concerning the study’s first aim showed that patients with HICP understand HRQOL as feeling seen and understood as a person by their social network, having a mission in life, and having control over their own lives.

References

1. Ekholm O, Diasso PDK, Davidsen M, Kurita GP, Sjøgren P. Increasing prevalence of chronic non-cancer pain in Denmark from 2000 to 2017: A population-based survey. Eur J Pain. 2022; 26(3):624–33.

2. Bruun KD, Vaegter HB, Bye-Møller L. High-Impact Chronic Pain. International Association for the Study of Pain (IASP) [Internet]. 2023 [cited 2024 Jan 22]. Available from: https://www.iasp-pain.org/resources/fact-sheets/high-impact-chronic-pain/.

3. Pak SS, Miller MJ, Cheuy VA. Use of the PROMIS-10 global health in patients with chronic low back pain in outpatient physical therapy: a retrospective cohort study. J Patient-Rep Outcomes. 2021; 5:81.

4. Cheng KF, Clark A. Qualitative Methods and Patient-Reported Outcomes: Measures Development and Adaptation. Int J Qual Methods. 2017; 16:160940691770298.

5. Hak T, Van der Veer K, Jansen H. The Three-Step Test-Interview (TSTI): An observation-based method for pretesting self-completion questionnaires. Surv Res Methods. 2008; 2:143–50.

Presenting Author

Emily Sophia Madley

Poster Authors

Emily Sophia Madley

BSc

ANAESTHESIOLOGY AND INTENSIVE CARE, Odense University Hospital

Lead Author

E-mail

Sophie Lykkegaard Ravn and PhD

Department of Psychology, University of Southern Denmark, DK

Lead Author

E-mail

Daniel Broholm

MSc physiotherapy

Lead Author

E-mail

Henrik Bjarke Vægter

MSc Pain Management

Lead Author

E-mail

Topics

  • Assessment and Diagnosis