Enduring versus curable: mixed-methods perspectives about pain among chiropractic patients.

Area of Science:

• Pain research
• Qualitative and quantitative methodologies
• Patient-centered care

Background:

• Limited literature exists on using qualitative research to inform quantitative studies on chronic pain.
• Patient perspectives are crucial for grounding quantitative research in lived experiences.
• Understanding patient perceptions of pain chronicity is key to appropriate care for spinal pain.

Purpose of the Study:

• To detail how qualitative data on chiropractic patients' perceptions of pain chronicity informed a national quantitative study.
• To integrate patient perspectives into the design of quantitative research protocols and pain measures.
• To explore how patients' understanding of chronic pain influences their care-seeking behaviors.

Main Methods:

• Exploratory sequential mixed methods study design.
• Conducted 40 semi-structured interviews and a mixed methods survey with 108 chiropractic patients.
• Thematic analysis of qualitative data informed a visual framework, which guided a quantitative survey of 2,025 chronic pain patients.

Main Results:

• Qualitative findings indicated many patients perceive chronic pain as permanent, shifting focus from cure to management and coping.
• Patient understanding of chronicity influenced their care-seeking and satisfaction, challenging assumptions about expected outcomes.
• This perception impacted how patients approached treatment and their overall satisfaction with care.

Conclusions:

• Qualitative findings significantly shaped the methods and interpretation of the quantitative observational research.
• The integration of qualitative data led to a refined conceptual framework for chronic pain.
• Resulted in more informative surveys and a deeper understanding of diverse patient beliefs driving care-seeking behaviors.