Background & Aims
Chronic pain poses a significant individual and societal burden, impacting physical, psychological and social well-being, while straining healthcare systems [1,2]. For people living with chronic pain, physiotherapy services are often used to enhance quality of life and reduce medication consumption [3,4]. To offer high-quality care, physiotherapy services should be patient-centred and responsive to patients’ needs [5]. However, our team recently conducted a scoping review which showed that no empirical studies had yet specifically asked individuals with chronic pain about their perceived needs regarding physiotherapy services. This qualitative study therefore aimed to understand the perceived needs of people living with chronic pain regarding their experiences of physiotherapy services.
Methods
In this qualitative study, people living with chronic pain who had received physiotherapy care took part in individual semi-structured interviews. They were recruited via the mailing lists of various chronic pain associations across the province of Quebec, Canada. Participants had to have received physiotherapy care in the previous three years, in any care setting (rehabilitation centre, hospital, chronic pain management clinic, private physiotherapy clinic). A purposive sampling was used to ensure diversity of participants based on gender, age, ethnicity, regions lived in, education level, annual income, employment status, type of chronic pain and type of setting where physiotherapy care was received. The interviews lasted approximately 75 minutes and were transcribed verbatim. They were then analyzed by inductive thematic analysis [6] using the NVivo software.
Results
Twenty-seven participants were interviewed (19 women, 8 men; 48% above 55 years old). The vast majority of participants had received services in at least one private physiotherapy clinic. Perceived needs were grouped under four main themes: 1) needing an interpersonal relationship based on respect and empathy; 2) needing personalized, collaborative care; 3) needing an adapted, warm environment that encourages communication; and 4) needing to receive care in a flexible organization that takes people’s well-being to heart. For example, many participants expressed the need to be seen by a physiotherapist who would take time to listen to them, to understand them (theme 1) and to collaborate (theme 2). Some also wanted to receive care in an intimate environment, with a more contemporary, less “medical” look, and a positive vibe (theme 3). Several participants mentioned the need for an organization that understood and adapted to the unexpectedness of living with chronic pain (theme 4).
Conclusions
Our study showed that people living with chronic pain have widely varying perceived needs with regard to physiotherapy. Many of these needs are directly related to the one-on-one interaction with the physiotherapist, in terms of both interpersonal relationships and professional care, while many others stem more from the environment and organizational aspects associated with physiotherapy services. In the end, these many needs seem interrelated and greatly influenced by the realities of living with chronic pain that is unpredictable, incapacitating and affects all spheres of life.
References
[1] Nicholas, M., Vlaeyen, J. W. S., et al. Treede, R.-D. (2019). The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain, 160(1), 28-37. doi:10.1097/j.pain.0000000000001390
[2] Gaskin, D. J., & Richard, P. (2012). The economic costs of pain in the United States. Journal of Pain, 13(8), 715-724. doi:10.1016/j.jpain.2012.03.009
[3] Marris, D., Theophanous, K., Cabezon, P., et al. (2021). The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials. Physiother Theory Pract, 37(4), 461-472. doi:10.1080/09593985.2019.1633714
[4] Wenger, S., Drott, J., Fillipo, R., et al. (2018). Reducing Opioid Use for Patients With Chronic Pain: An Evidence-Based Perspective. Physical Therapy, 98(5), 424-433. doi:10.1093/ptj/pzy025
[5] Cook, C. E., Denninger, T., Lewis, J., et al. (2021). Providing value-based care as a physiotherapist. Archives of Physiotherapy, 11(1), 1-5. doi:10.1186/s40945-021-00107-0
[6] Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi:10.1191/1478088706qp063oa
Presenting Author
Jonathan Gervais-Hupé
Poster Authors
Jonathan Gervais-Hupé
MSc
Université de Montréal
Lead Author
Arthur Filleul
MSc
Université Grenoble Alpes, France
Lead Author
Kadija Perreault
PhD
Center for Interdisciplinary Research in Rehabilitation and Social Integration, Canada
Lead Author
Isabelle Gaboury
PhD
Department of family medicine and emergency medicine, University of Sherbrooke, Canada
Lead Author
Timothy Wideman
McGill University
Lead Author
Céline Charbonneau
Association québécoise de la douleur chronique, Canada
Lead Author
Fatiha Loukili
Association des personnes vivant avec de la douleur chronique, Canada
Lead Author
Anne Hudon
PhD
School of rehabilitation, Faculty of medicine, Université de Montréal, Canada
Lead Author
Topics
- Treatment/Management: Interventional Therapies – Other