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

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

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
Volume2017
Issue number12
DOIs
Publication statusPublished - 8 Nov 2017

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Rehabilitation
Pain
Lung
Health Personnel
Chronic Obstructive Pulmonary Disease
Exercise
Education
Muscle Strength
Pain Management
Dyspnea
Fear
Anxiety
Demography
Interviews
Equipment and Supplies

Bibliographical note

© 2017 Harrison et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).

Cite this

Harrison, Samantha ; Lee, Annemarie ; Button, Helene ; Shea, Rebecca ; Goldstein, Roger ; Brooks, Dina ; Ryan, Cormac ; Martin, Denis. / The role of pain in pulmonary rehabilitation: a qualitative study. In: International journal of chronic obstructive pulmonary disease. 2017 ; Vol. 2017, No. 12. pp. 3289—3299.
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The role of pain in pulmonary rehabilitation: a qualitative study. / Harrison, Samantha; Lee, Annemarie; Button, Helene; Shea, Rebecca; Goldstein, Roger; Brooks, Dina; Ryan, Cormac; Martin, Denis.

In: International journal of chronic obstructive pulmonary disease, Vol. 2017, No. 12, 08.11.2017, p. 3289—3299.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Goldstein, Roger

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AU - Martin, Denis

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N2 - 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.

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