Detailed Description

Purpose of Study: Millions of people suffer from chronic pain on a daily basis. For any given chronic pain problem, certain individuals seem to have been able to overcome many or most of the manifestations of their pain. Specifically, pain per se no longer seems to play a prominent role in the daily existence of these individuals. Our clinical experience has been that such individuals will report persistence of pain when specifically asked about its presence, but they no longer experience significant suffering. We believe these individuals have much to teach us regarding chronic pain and its treatment.

The purpose of this study is to interview individuals who feel they have ‘overcome’ chronic pain. We specifically use the term ‘overcome’ because of its neutrality regarding presence or absence (ie. persistence) of pain. The interview process will be completely open-ended, instructing the participant to provide a narrative account of their particular experience of ‘overcoming’ their chronic pain. The narrative histories will then be studied using a systematic dimensional analysis approach to determine the presence or absence of specific patterns of behavior, thought, or activity leading to improvement in the overall condition of chronic pain and its manifestations. It is the expectation of the investigators that the results of this study will assist in the development of future, more targeted studies aimed at treating chronic pain disorders more effectively.

Sponsor of Study: There are no corporate or government sponsors.

Investigator’s qualifications for conducting the study: Dr. Meyer and Dr. Rooney both have experience in clinical research and are active board-certified and clinically licensed practitioners who treat chronic pain sufferers in the Mid-Missouri community.

Study design (including rationale for research methods & statistical design):

Because the nature of the current study is a preliminary and exploratory investigation of the subjective experiences of participants who have successfully dealt with living with chronic pain, we have chosen a grounded theory/dimensional analysis approach to these data. Interpretive/Qualitative data analyses are appropriate when 1) little is known about the subjective phenomena under investigation, and 2) researchers want to be cautious about bringing a priori dimensions to the subjective experiences of the research participants (given, as stated, that very little is known about potential commonalities or phenomena of the experience in a given population). The purpose of utilizing a grounded theory/dimensional analysis approach that brings an unstructured interview to research participants, is to allow the participants themselves to provide the relevant dimensions of their subjective experiences. In this manner, we will be able to complete a dimensional analysis of the interviews that will provide categories (or variables) that will inform future, and confirmatory, quantitative analyses.

Because this approach may be less familiar, an illustration is provided here. If an investigator decided to study lack of compliance in the medical treatment of a specific disease, they could assume that attitude toward medication, in general, was an important variable. The investigator would choose an existing measure of Attitudes toward Medicine that had good statistical properties and proceed with the investigation. If, on the other hand, a researcher decided to use a grounded theory/dimensional analysis approach and simply began a research interview with the sentence, “Tell me about your experience taking medicine for your diagnosis” it would allow the data from the participants to determine whether attitudes toward medicines in general was, indeed, an important variable—or, if other variables were more salient in these participants’ experiences. These data would then inform the selection of which quantitative measures were available, if new quantitative measures needed to be developed, and what statistical analyses and models would be most appropriate for future research endeavors.