The decisional balance: an interpretative phenomenological analysis reflecting the transition from pain management services to chronic pain support group attendance

Finlay, Katherine A. and Elander, James (2016) The decisional balance: an interpretative phenomenological analysis reflecting the transition from pain management services to chronic pain support group attendance. The British Journal of Health Psychology, 21 (3). pp. 660-676. ISSN 2044-8287

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Abstract

OBJECTIVES: Transitioning from clinical care to community-based self-management represents a significant challenge, throughout which social support can facilitate health adjustment and quality of life. However, community-centred, peer-led support structures are often underused. This study aimed to investigate the decision-making processes involved in the choice to attend a chronic pain support group (CPSG) following discharge from a Pain Management Programme. DESIGN: An in-depth, qualitative analysis was undertaken using interpretative phenomenological analysis, exploring participants' subjective experiences, decision-making, and rationale for initial CPSG attendance. METHODS: Twelve participants (four males, eight females) were recruited from a regional CPSG and completed semi-structured interviews lasting between 45 and 120 min. Interviews were transcribed verbatim and analysed idiographically before a cross-case analysis was completed. RESULTS: Analysis of transcripts resulted in three superordinate themes: (1) The thirst for comparative friendship; (2) conjecture and the imminent choice; (3) progressive pain management. These themes reflect a desire for empathic, socially comparative friendships and the search for a forum in which to enhance pain self-management strategies, yet also internal conflict over initial CPSG attendance. CONCLUSION: Social support and associated friendships are attractive to prospective CPSG members and are conceptualized as opportunities to engage in social comparison and nurture self-care. The first visit to the support group presents a significant hurdle, but can be facilitated by managing the transition between therapeutic care and CPSG attendance. Clinicians can challenge preconceptions, foster positive viewpoints regarding the group and support collective decision-making to attend. Following initial attendance, psychosocial well-being was enhanced. Statement of contribution What is already known on this subject? Social support functions as a protective buffer against declining health. Joining a peer-led support group can be initially intimidating and the first visit presents a significant hurdle. What does this study add? Participants are predominantly attracted to support groups due to the opportunity to develop new friendships. Health-related peer groups function as fora for social comparison, enhancing self-esteem and self-efficacy. Experience of pain management programmes primes willingness to attend support groups. The initial decision to attend is difficult but facilitated by collective, group decision-making processes. Health care professionals dynamically prime the transition towards peer support structures.

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