TY - JOUR
T1 - Subgroup Perspectives on Chronic Pain and Its Management After Spinal Cord Injury
AU - Widerström-Noga, Eva
AU - Anderson, Kim D.
AU - Perez, Salomé
AU - Martinez-Arizala, Alberto
AU - Cambridge, Jessica M.
N1 - Funding Information:
Funded by a US Department of Defense grant (SC110195/ SC140052). The funding sources did not have any involvement in the study design; data collection, analysis, and interpretation; writing of this article, or the decision to submit this article for publication. The authors have no conflicts of interest to declare.
PY - 2018/12
Y1 - 2018/12
N2 - The present study was part of a larger mixed-methods study concerning facilitators and barriers to living with chronic pain after spinal cord injury. The agreement with themes obtained in qualitative interviews were quantified in a large online survey and overarching themes were defined by factor analysis. The present study aimed to define subgroups based on cluster analysis of the overarching themes’ factor scores and to compare the subgroups on pain-related variables. Three subgroups—high pain impact, moderate pain impact, and low pain impact—emerged. The high pain impact subgroup experienced severe pain with neuropathic pain characteristics; used pain medication, multiple coping strategies, and self-remedies; and considered information about pain and its management critical, but were not able to communicate well about their pain. The moderate pain impact subgroup carried on despite pain, considered pain information important, and used multiple approaches to manage their pain, but used less medication owing to concerns about side effects and addiction. The low pain impact subgroup considered information about pain, pain treatments, and communication regarding pain less important than the other subgroups did. This study suggests that treatment approaches need to be individually tailored not only to type of pain, but also to personal factors and preferences. Perspective: People who experience significant pain impact after spinal cord injury use multiple approaches to manage their pain. Many have concerns about side effects and addiction, and consider information about pain and its management, including pharmacologic, nonpharmacologic, and self-remedies, a high priority. Therefore, patients’ personal preferences may provide additional tailoring options for patient-centered treatments.
AB - The present study was part of a larger mixed-methods study concerning facilitators and barriers to living with chronic pain after spinal cord injury. The agreement with themes obtained in qualitative interviews were quantified in a large online survey and overarching themes were defined by factor analysis. The present study aimed to define subgroups based on cluster analysis of the overarching themes’ factor scores and to compare the subgroups on pain-related variables. Three subgroups—high pain impact, moderate pain impact, and low pain impact—emerged. The high pain impact subgroup experienced severe pain with neuropathic pain characteristics; used pain medication, multiple coping strategies, and self-remedies; and considered information about pain and its management critical, but were not able to communicate well about their pain. The moderate pain impact subgroup carried on despite pain, considered pain information important, and used multiple approaches to manage their pain, but used less medication owing to concerns about side effects and addiction. The low pain impact subgroup considered information about pain, pain treatments, and communication regarding pain less important than the other subgroups did. This study suggests that treatment approaches need to be individually tailored not only to type of pain, but also to personal factors and preferences. Perspective: People who experience significant pain impact after spinal cord injury use multiple approaches to manage their pain. Many have concerns about side effects and addiction, and consider information about pain and its management, including pharmacologic, nonpharmacologic, and self-remedies, a high priority. Therefore, patients’ personal preferences may provide additional tailoring options for patient-centered treatments.
KW - SCI
KW - chronic pain
KW - mixed-methods research
KW - neuropathic
KW - psychosocial
KW - subgroups
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U2 - 10.1016/j.jpain.2018.07.003
DO - 10.1016/j.jpain.2018.07.003
M3 - Article
C2 - 30056113
AN - SCOPUS:85052976439
VL - 19
SP - 1480
EP - 1490
JO - Journal of Pain
JF - Journal of Pain
SN - 1526-5900
IS - 12
ER -