Background Chronic pain is generally associated with low activity level, low work capability, and negative health consequences (1). Education and exercise have shown effective results for patients with chronic pain (2), and is according to EULAR 2016 recommendations first line interventions for patients with fibromyalgia (3). This educational program “Pain school - Competence for life” for patients with chronic pain was developed by the Swedish Rheumatoid Association together with health care professionals for use in primary health care, but is not previously evaluated. The pedagogy is based on a biopsychosocial perspective and self-efficacy with the purpose to provide knowledge, experience and skills within pain, balance of daily living and physical activity. The program comprises four educational group sessions and 10 weeks of physical activity.
Objectives To gather deeper knowledge about how patients with chronic widespread pain experienced participation in the Pain school –Competence for life”, with focus on changes in perception of pain and/or lifestyle.
Methods 12 women (age 25–72 years) with chronic widespread pain were included in this qualitative interview study set in primary health care. Informed consent were signed by all participants. Semi-structured individual interviews were held 10 weeks after completion of four educational group sessions. Interviews were conducted by two authors and transcribed verbatim.
Results One theme and four categories were identified. An overarching theme, describing the participants' experiences of the educational program, was a meaningful learning process. It covered four categories: increased understanding of body and mind, new strategies and ways of thinking, experienced value of participation, and preconditions for change. Participants described increased knowledge, awareness and acceptance relating to their symptoms and limitations. They expressed new strategies relating to managing pain, physical activity, and everyday life. Both individual and social value of participation was described, such as increased well-being, decreased anxiety and improved relationships. Group dynamics, structure of education and former knowledge was described to predispose change in perception of pain and lifestyle.
Conclusions The results provide deeper knowledge about patients' experiences of the educational program Pain School Competence for life. The educational program appears to provide a meaningful and well-functioning structure for education for patients with chronic widespread pain in primary health care. Further, this can contribute to improve education and rehabilitation for patients with CWP provided by physiotherapists and occupational therapists in primary health care.
Harker J, Reid KJ, Bekkering GE, Kellen E, Bala MM, Riemsma B, et al. Epidemiology of chronic pain in denmark and sweden. Pain Res Treat. 2012; 1–30.
Hassett AL, Williams DA. Non-pharmacological treatment of chronic widespread musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25: 299–309.
Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2016;0: 1–11.
Disclosure of Interest None declared