The role of pain in pulmonary rehabilitation: a qualitative study

Samantha Harrison, Annemarie Lee, Helene Button, Rebecca Shea, Roger Goldstein, Dina Brooks, Cormac Ryan, Denis Martin

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    Introduction: One third of individuals with chronic obstructive pulmonary disease (COPD) report pain. To help inform a COPD-specific pain intervention, we explored the views of health care providers (HCPs) and individuals with COPD on pain during pulmonary rehabilitation (PR).
    Methods: This is a qualitative study using inductive thematic analysis. Eighteen HCPs familiar with PR and 19 patients enrolled in PR participated in semi-structured interviews. Demographic data were recorded, and the patients completed the Brief Pain Inventory (Short Form).
    Results: 1) Interaction between pain and COPD: pain is a common experience in COPD, heightened by breathlessness and anxiety. 2) Pain interfering with PR: a) Communicating pain: HCPs rarely ask about pain and patients are reluctant to report it for fear of being removed from PR. b) PR is a short-term aggravator but long-term reliever: although pain limits exercise, concentration, and program adherence, PR may reduce pain by increasing muscle strength and improving coping. c) Advice and strategies for pain: some attention is given to pain management but this is often counterproductive, encouraging patients to cease exercise. 3) An intervention to manage pain: HCPs were enthusiastic about delivering a pain intervention within their knowledge and time constraints. Early group education was preferred.
    Conclusion: A pain intervention seems warranted in PR and may improve adherence and therefore clinical benefit. A pain intervention could be provided as part of PR education with HCP training.
    Original languageEnglish
    Pages (from-to)3289—3299
    JournalInternational journal of chronic obstructive pulmonary disease
    Issue number12
    Publication statusPublished - 8 Nov 2017

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