Diminishing pain stigma: patient perceptions of encounters with interprofessional teams in biopsychosocial pain rehabilitation

Abstract

Purpose: To explore how patients in biopsychosocial pain rehabilitation perceive encounters with interprofessional teams. The focus of this article is to explore how interactions can perpetuate or diminish chronic pain stigma. Material and methods: An ethnographic approach was applied to the study. Participant observation of interprofessional encounters and clinical encounters in a pain rehabilitation ward was undertaken in 2016 (19 weeks). Interviews with 12 professionals and seven patients were conducted. Data were analysed in an abductive process using thematic analysis. Results: The patients perceived their encounters with interprofessional teams as supportive, with implications for pain stigma. This is presented as two themes: (1) being seen as credible, involving patients being believed in and a concept of being overactive at the expense of their own health, and (2) being helped to see their situation in a new light, which involves enthusiasm about changing and challenging views in a process with professionals who were supportive and united across professions. Conclusion: Interprofessional biopsychosocial pain rehabilitation may be an intervention that can diminish internalised stigma in patients suffering from chronic pain. The study contributes to increased understanding of patient perceptions of positive encounters with professionals during a learning process in rehabilitation and of the imbued influence on power relations. This appears to be fundamental to diminishing pain stigma, as the occurrence of stigma is dependent on differences in power.KEY MESSAGES Interprofessional biopsychosocial pain rehabilitation can be an intervention for diminishing internalised pain stigma in patients. Knowledge on how encounters with professionals induce personal learning processes among people with chronic pain.