Neuropathic pain in a rehabilitation setting after spinal cord injury: an interpretative phenomenological analysis of inpatients’ experiences

Spinal Cord Series and Cases, 2017 · DOI: https://doi.org/10.1038/s41394-017-0032-9 · Published: November 25, 2017

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

This study explores the experiences of people with spinal cord injuries who are also experiencing neuropathic pain during their rehabilitation. The goal is to better understand how this pain affects their rehabilitation process. Researchers conducted interviews with eight individuals at a spinal cord injury center in the UK. The interviews focused on their experiences with pain, how they coped, and their perceptions of their rehabilitation environment. The study found that feeling safe in the hospital environment, having trust in the staff, and managing expectations about pain relief are important factors in how people cope with pain and engage in rehabilitation.

Study Duration

Not specified

Participants

8 (5 males, 3 females) with SCI and chronic NP

Evidence Level

Qualitative study, interpretative phenomenological analysis

Key Findings

1
Participants' perceptions of safety in the hospital environment (feeling confined versus feeling sheltered) influenced their emotional security and adherence to pain management.
2
Attitudes toward medication varied widely, with some participants expressing desperation for complete pain relief while others felt resigned or indifferent to medication.
3
Participants' future-oriented discussions revealed uncertainty about whether pain would persist, with some hoping for complete relief and others accepting the likelihood of ongoing pain.

Research Summary

This qualitative study explores the lived experiences of individuals with spinal cord injury (SCI) and neuropathic pain (NP) during inpatient rehabilitation, using interpretative phenomenological analysis (IPA) of interviews. Three super-ordinate themes emerged: (1) the dichotomy of safety perceptions; (2) adherence despite adversity; and (3) ﬁghting the future, highlighting the importance of the environment, staff empathy, and managing expectations about pain relief. The study emphasizes the need for tailored psycho-educational interventions that address individual needs and expectations, promoting alternative strategies and acceptance rather than solely relying on long-term medication for pain relief.

Practical Implications

Enhance Feelings of Safety

Healthcare providers should focus on creating a safe and supportive environment, fostering trust and open communication with patients to improve their emotional well-being and engagement in rehabilitation.

Manage Pain Expectations

Clinicians should address patient expectations about pain relief early in rehabilitation, providing realistic information and promoting alternative pain management strategies alongside medication.

Promote Adaptive Coping Strategies

Interventions such as coping effectiveness training, cognitive behavioral pain management, and acceptance-based interventions can help patients develop adaptive responses to pain and improve their overall adjustment to SCI.

Study Limitations

1
Small sample size, primarily composed of individuals over 60, limiting generalizability to the wider SCI population.
2
Self-selecting sample may have introduced bias, as those effectively managing NP may have been less motivated to participate.
3
The nature of the IPA methodology limits the degree to which conclusions can be drawn about causal links between themes.

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