ORIGINAL RESEARCH ARTICLE
Chaos to Hope: A Narrative of Healing
Version of Record online: 12 APR 2013
Wiley Periodicals, Inc
Volume 14, Issue 12, pages 1826–1838, December 2013
How to Cite
Zheng, Z., Paterson, C., Ledgerwood, K., Hogg, M., Arnold, C. A. and Xue, C. C. L. (2013), Chaos to Hope: A Narrative of Healing. Pain Medicine, 14: 1826–1838. doi: 10.1111/pme.12108
Zhen Zheng is a chief investigator of a National Health and Medical Research Council (NHMRC)-funded clinical trial investigating the role of acupuncture in reducing opioid medication consumption by patients with chronic non-cancer pain. The current qualitative study is nested in the trial. Zhen Zheng also receives financial support from the Helen MacPherson Smith Trust for the current study and from NHMRC for one other acupuncture trial for headache.
Charlotte Paterson received RMIT Foundation International Visiting Fellowship and a research grant from the School of Health Sciences, RMIT University.
Kay Ledgerwood was paid by a research grant from Helen MacPherson Smith Trust to interview participants, collect, and analyze data for this study.
Malcolm Hogg is an associate researcher and has been involved in a large international opioid trial supported by Purdue International. His employer has received honoraria from Janssen-Cilag and Mundipharma Pty Ltd for his involvement in general practitioner opioid education programs.
Carolyn Arnold is an associate researcher and has no competing interests.
Charlie Xue is a chief investigator of an NHMRC-funded clinical trial investigating the role of acupuncture in reducing opioid medication consumption by patients with chronic non-cancer pain. The current qualitative study is nested in the trial. Charlie Xue also receives financial support from NHMRC for five other trials.
This article describes a qualitative study in which patients taking opioid medications for chronic non-cancer pain were interviewed for their experience of using these medications. We identified three patterns of experience and illustrated the importance of support, hope, and access to specialist and complementary services.
- Issue online: 11 DEC 2013
- Version of Record online: 12 APR 2013
- Helen MacPherson Smith Trust. Grant Number: 6549
- National Health & Medical Research Council. Grant Number: 555411
- Chronic Pain;
- Qualitative Research;
- Patients' Experience;
To investigate the progression of the illness and opioid journeys of people who are taking opioids for chronic non-cancer pain.
In-depth qualitative interviews were conducted with 20 people who were taking opioids for non-cancer pain. A purposive sample was drawn from patients attending two pain clinics in Melbourne, Australia. Transcripts were analyzed within case, as individual narratives, and across case, as a thematic analysis. Conceptual explanatory variables were developed.
The experience of taking opioids for chronic non-cancer pain varies greatly between individuals and these diverse narratives—chaos, restitution, and quest narratives—raise questions about why and how some individuals find a way forward, while others remain in situations of chaotic and worsening ill health. We offer an explanation for this variability in terms of four key influences: support from individual health professionals and the health system; medical explanation or solutions; social support and social responsibilities; and the use of non-pharmaceutical interventions and self-help strategies. A unifying theme was the importance of maintaining hope.
The four key factors influencing the progress of people taking opioids for chronic non-cancer pain are rooted in the provisions made by society for caring for this patient group and involve relationships between patient and provider, between patients and their social world, and between different providers and their professional knowledge. In our patient sample, effective support involved the provision and maintenance of hope, and professionals who are knowledgeable about opioids and chronic pain, good communicators, and cognizant with their patients' social support and responsibilities.