Power over pain – An interprofessional approach to chronic pain: Program feedback from a medically underserved community, Bryl et al, 2021

Andy

Andy

Retired committee member
Introduction

The management of chronic pain is challenging. Biopsychosocial models recommend interprofessional approaches to treatment, but there is sparse information about participants' experiences of these programs, especially in medically underserved populations coping with the intersectionality of racial bias, low socioeconomic status, and psychosocial stressors. This study explored the perspectives and experiences of black participants with low socioeconomic status and concomitant psychosocial stressors in an outpatient interprofessional pain management program, Power over Pain. The program incorporates cognitive‐behavioural techniques, creative arts therapies, pain education, and psychoeducation about stress management, self‐care, exercise, and medication.

Method
This study employed thematic analysis as the qualitative research method. We conducted semi‐structured interviews with nine program participants. Interview questions focused on the impact of the program on participants' overall health and wellbeing and ability to manage chronic pain.

Results
Thematic analysis revealed the following treatment benefits as perceived by the participants: (a) moving from feeling stuck to feeling empowered, (b) enhanced understanding of chronic pain resulting in cognitive reframing and debunking certain myths and stigmas, (c) learning new pain management strategies, and (d) social support.

Conclusion
The findings suggest that the Power over Pain program may be an effective way to improve self‐management and empower medically underserved people who have chronic pain.
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Paywall, https://onlinelibrary.wiley.com/doi/full/10.1111/jep.13552
 
I just looked over the full text, and I notice that there didn't seem to be any mechanism, either in the questions posed or in the thematic analysis approach, for identifying anything other than positive statements about the programme. There was a question about "overall experience", but that was all.

Add to that the kinds of response biases and other sorts of biases likely to operate when people involved in delivering a programme interview their own participants (and code their responses), it doesn't seem to add up to much. And all that "intersectionality" (participants were black and also from low SES backgrounds) would most likely work to further enhance those biases, because of the bigger power differential between the researchers/clinicians and the participants.

The worrying thing is that, irrespective of these limitations, the paper will no doubt become an addition to the list of "positive evidence" that is cited in favour of these types of programmes.
 
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