Article

Self-management interventions fostering self-efficacy improve the
well-being of people with chronic pain. The purpose of this study was to
synthesize the enablers (what works) and barriers (what does not) of
incorporating self-management strategies for people in everyday life after
completion of a pain self-management intervention.
Data Sources: Major electronic
databases (MEDLINE, AMED, PsycINFO, Cochrane Library, PubMed, CINAHL, Scopus, and
Google Scholar) were searched from inception to July 2016. Study Selection: Study
selection included qualitative and mixed-method studies that explored the
perceptions of individuals with chronic pain after completion of a
self-management intervention. Data Extraction: A thematic analysis approach was
used to synthesize the review findings, and a Confidence in the Evidence from
Reviews of Qualitative Research (CERQual) Approach was used to assess the level
of confidence. Data Synthesis: Thirty-three studies with 512 participants were
included. Enablers to self-management included self-discovery-the ability to
distinguish self (ie, body, thoughts, and feelings) from pain; feeling empowered
by incorporating self-management strategies into practice; and supportive
ambience via collaborative relationships with clinicians and support from family
and friends. Barriers to self-management included difficulty with sustaining
motivation for pain self-management; distress experienced from ongoing pain,
anxiety, and depression; and unsupportive relationships with clinicians, family,
and friends. Limitations: This review only included interventions that involved
at least 4 self-management skills; thus, informative studies may have been
missed. The follow-up period varied from immediately after the intervention to 72
months following the intervention; therefore, it is uncertain which of the key
enablers and barriers were most influential long term. Only articles published in
the English language were included; studies conducted in low- and middle-income
countries could not be located. Conclusions: The sustained effort to self-manage
chronic pain could be exhausting, and motivation could wane over time following
intervention. Providing intermittent support in the form of booster sessions and
peer support groups may be important. Person-centered care via shared decision
making and guided problem solving is essential to facilitating ongoing self-management.

Langue : ANGLAIS