Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2009 Oct;10(7):1280-90.
doi: 10.1111/j.1526-4637.2009.00707.x.

Barriers and facilitators to chronic pain self-management: a qualitative study of primary care patients with comorbid musculoskeletal pain and depression

Matthew J Bair  1 , Marianne S Matthias, Kathryn A Nyland, Monica A Huffman, Dawana L Stubbs, Kurt Kroenke, Teresa M Damush
Affiliations
Multicenter Study

Barriers and facilitators to chronic pain self-management: a qualitative study of primary care patients with comorbid musculoskeletal pain and depression

Matthew J Bair et al. Pain Med. 2009 Oct.

Abstract

Objective: To identify barriers and facilitators to self-management of chronic musculoskeletal pain among patients with comorbid pain and depression.

Design: A qualitative study using focus group methodology.

Setting: Veteran Affairs (VA) and University primary care clinics.

Patients: Recruited after participation in a clinical trial.

Intervention: The Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) trial tested an intervention of optimized antidepressant therapy combined with a pain self-management program versus usual care for primary care patients with comorbid chronic pain and depression.

Outcome measures: Thematic content analysis from focus group data was used to identify patient-perceived barriers and facilitators to self-management of chronic musculoskeletal pain.

Results: Patients (N = 18) were 27 to 84 years old (M = 54.8), 61% women, 72% white, and 22% black. Barriers to pain self-management included: 1) lack of support from friends and family; 2) limited resources (e.g., transportation, financial); 3) depression; 4) ineffectiveness of pain-relief strategies; 5) time constraints and other life priorities; 6) avoiding activity because of fear of pain exacerbation; 7) lack of tailoring strategies to meet personal needs; 8) not being able to maintain the use of strategies after study completion; 9) physical limitations; and 10) difficult patient-physician interactions. Facilitators to improve pain self-management included 1) encouragement from nurse care managers; 2) improving depression with treatment; 3) supportive family and friends; and 4) providing a menu of different self-management strategies to use.

Conclusions: Future research is needed to confirm these findings and to design interventions that capitalize on the facilitators identified while at the same time addressing the barriers to pain self-management.

PubMed Disclaimer

References

    1. Peter D. Hart Research Associates. America speaks: Pain in America survey. 2003. Accessed from http://www.researchamerica.org/uploads/poll2003pain.pdf.
    1. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290:2443–2454. - PubMed
    1. Turk DC, Okifuji A, Kalauolalani D. Clinical outcome and economic evaluation of multidisciplinary pain centers. In: Block AR, Kremer EF, Fernandez E, editors. Handbook of pain syndromes: Biopsychosocial perspectives. Mahway, NJ: Erlbaum; 1999. pp. 77–98.
    1. Gu X, Belgrade MJ. Pain in hospitalized patients with medical illnesses. J Pain Symptom Manage. 1993;8:17–21. - PubMed
    1. Donovan M, Dillon P, McGuire L. Incidence and characteristics of pain in a sample of medical-surgical inpatients. Pain. 1987;30:69–78. - PubMed

Publication types

MeSH terms