Supporting people with pain-related distress in primary care consultations: a qualitative study
Supporting people with pain-related distress in primary care consultations: a qualitative study
Background Low mood and distress are commonly reported by people who have persistent musculoskeletal (MSK) pain, which may be labelled as 'depression'. It is important to understand how pain-related distress is conceptualised and managed in primary care consultations. Aim To explore understanding of pain-related distress and depression from the perspectives of people with persistent MSK pain and GPs. Design and setting Qualitative study with people with persistent MSK pain and GPs from different parts of the UK. Method Semi-structured interviews conducted remotely and data analysed thematically. Results Most participants reported challenges in distinguishing between distress and depression in the context of persistent MSK pain, but also described strategies to make this distinction. Some people described how acceptance of their situation was key and involved optimism about the future and creation of a new identity. Some GPs expressed 'therapeutic nihilism', with uncertainty about the cause of pain and how to manage people with both persistent MSK pain and distress in primary care consultations, while GPs who could identify and build on optimism with patients described how to help the patient to move forwards. Conclusion This study offers a framework for the primary care consultation with patients presenting with pain-related distress. GPs should recognise the impact of persistent MSK pain on the patient and support the person in coming to terms with their pain, explore how the person feels about the future, encourage optimism, and support self-management strategies.
depression, general practitioners, pain, pain management, referral and consultation, self-management
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Shivji, Noureen
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Geraghty, Adam
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Birkenshaw, Hollie
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Pincus, Tamar
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Johnson, Helen
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Little, Paul
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Moore, Michael
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Stuart, Beth
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Chew-Graham, Carolyn
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November 2022
Shivji, Noureen
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Geraghty, Adam
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Birkenshaw, Hollie
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Pincus, Tamar
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Johnson, Helen
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Little, Paul
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Moore, Michael
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Stuart, Beth
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Chew-Graham, Carolyn
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Shivji, Noureen, Geraghty, Adam, Birkenshaw, Hollie, Pincus, Tamar, Johnson, Helen, Little, Paul, Moore, Michael, Stuart, Beth and Chew-Graham, Carolyn
(2022)
Supporting people with pain-related distress in primary care consultations: a qualitative study.
British Journal of General Practice, 72 (724), .
(doi:10.3399/BJGP.2022.0120).
Abstract
Background Low mood and distress are commonly reported by people who have persistent musculoskeletal (MSK) pain, which may be labelled as 'depression'. It is important to understand how pain-related distress is conceptualised and managed in primary care consultations. Aim To explore understanding of pain-related distress and depression from the perspectives of people with persistent MSK pain and GPs. Design and setting Qualitative study with people with persistent MSK pain and GPs from different parts of the UK. Method Semi-structured interviews conducted remotely and data analysed thematically. Results Most participants reported challenges in distinguishing between distress and depression in the context of persistent MSK pain, but also described strategies to make this distinction. Some people described how acceptance of their situation was key and involved optimism about the future and creation of a new identity. Some GPs expressed 'therapeutic nihilism', with uncertainty about the cause of pain and how to manage people with both persistent MSK pain and distress in primary care consultations, while GPs who could identify and build on optimism with patients described how to help the patient to move forwards. Conclusion This study offers a framework for the primary care consultation with patients presenting with pain-related distress. GPs should recognise the impact of persistent MSK pain on the patient and support the person in coming to terms with their pain, explore how the person feels about the future, encourage optimism, and support self-management strategies.
Text
BJGP.2022.0120.full
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More information
Accepted/In Press date: 11 May 2022
e-pub ahead of print date: 23 May 2022
Published date: November 2022
Additional Information:
Funding Information:
This study was funded by Versus Arthritis (grant number: 22454). Carolyn A Chew-Graham is part-funded by National Institute for Health and Care Research Applied Research Collaboration West Midlands.
Publisher Copyright:
© The Authors.
Keywords:
depression, general practitioners, pain, pain management, referral and consultation, self-management
Identifiers
Local EPrints ID: 468733
URI: http://eprints.soton.ac.uk/id/eprint/468733
ISSN: 0960-1643
PURE UUID: f9930aeb-a8c5-4962-bec6-4e601043e913
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Date deposited: 24 Aug 2022 16:34
Last modified: 17 Mar 2024 03:21
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Contributors
Author:
Noureen Shivji
Author:
Hollie Birkenshaw
Author:
Tamar Pincus
Author:
Helen Johnson
Author:
Carolyn Chew-Graham
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