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Understanding Pain Expression Using Visual Art: A Qualitative Study of the Artistic Pain Exploration Tool in Patients
Razan M Baabdullah1, Nada J Farsi2, Mona T Rajeh2
1Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Background:
Pain associated with temporomandibular disorders (TMD) is multifaceted, often eluding conventional pain assessment tools that prioritize biomedical metrics over emotional and experiential dimensions. Arts-based research has shown promise in capturing the complexity of chronic pain, offering patients alternative modes of expression and clinicians' richer insight into subjective experiences.
Objective:
This study explores how the Artistic Pain Exploration (APE) tool, a novel, art-based pain assessment method, supports patients with TMD in articulating their pain experiences across emotional, symbolic, and sensory domains.
Methods:
Using a phenomenological approach, semi-structured interviews were conducted with 18 patients diagnosed with early-stage TMD (12 male, 6 female; 13 Wilkes' stage I, 5 stage II), purposively sampled from the intervention arm of an ongoing randomized controlled trial comparing the APE tool with conventional pain assessment. Each participant selected one of three curated artworks that resonated with their pain and used it as a prompt during the interview, which followed the structured APE script. Data were analyzed using Moustakas' modified Stevick-Colaizzi-Keen method.
Results:
Five major themes emerged: (1) Pain as a Daily Ritual, (2) Adaptation and Coping, (3) Limited Emotional Impact of Pain (4) Pain Triggered by Stress or Emotional States, and (5) Disruption of Social and Functional Activities. The APE tool enabled deeper narrative expression and helped patients externalize and make sense of their pain.
Conclusion:
Among adults with early-stage TMD, APE-guided interviews elicited descriptions of sensory, emotional, functional, and coping-related aspects of pain. The findings suggest that the APE approach may provide a structured visual prompt to support discussion of patients' lived experiences. Because this exploratory qualitative study did not compare APE with conventional interviews, further research is needed to determine its distinctive contribution to pain assessment.
