Exploring Self-Management Barriers and Facilitators Experience by People with Chronic Musculoskeletal Pain - A Qualitative Study

BackgroundOne in three people worldwide will experience chronic musculoskeletal pain (CMP). Due to the long-standing nature of CMP, it is inevitable that people with CMP will have to engage in some form of self-management. As highlighted by multiple clinical practice guidelines, it becomes pivotal that healthcare professionals provide effective self-management support. However, the current effectiveness of self-management interventions seems equivocal. This may be due to self-management interventions not being developed based on an in-depth understanding of the self-management challenges experienced by people with CMP. ObjectivesThis study explored the everyday barriers and facilitators for self-management experienced by people with CMP currently undergoing rehabilitation in a municipality setting. MethodsWe conducted 11 one-time, single-person, qualitative interviews of people living with CMP. The interviews were based on a semi-structured interview guide with open-ended questions and analyzed using an inductive thematic analysis to identify the participants experienced barriers and facilitators for self-management in everyday situations. FindingsThree overarching barriers emerged: 1) biographical disruption, 2) uncertainty and psychological distress, and 3) lack of social support. Further, three overarching facilitators emerged: 1) acceptance and optimism 2) pain-relieving strategies and 3) social support. These barriers and facilitators far exceeded participants capability to control their pain. ConclusionThe majority of the barriers and facilitators concerned the management of cognitive, emotional, social or personal consequences of CMP. Integrating these barriers and facilitators into the development of future self-management interventions may have the potential to improve the effectiveness of these interventions. SignificanceQualitative studies exploring self-management of chronic pain traditionally focus on identification of barriers for pain-management. This study identified several interconnected barriers and facilitators which influenced CMP patients everyday self-management. This provided targets for designing self-management interventions to support patients pain-related, psychological, and social self-management practices in everyday contexts. O_TBL View this table: org.highwire.dtl.DTLVardef@94ebaorg.highwire.dtl.DTLVardef@10f9d8forg.highwire.dtl.DTLVardef@3141e3org.highwire.dtl.DTLVardef@1dcb1aborg.highwire.dtl.DTLVardef@1488df_HPS_FORMAT_FIGEXP M_TBL C_TBL