A narrative approach to explore grief experiences and treatment adherence in people with chronic pain after participation in a pain-management program: a 6-year follow-up study

Abstract

Elin Dysvik,1 Gerd Karin Natvig,2 Bodil Furnes31Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, Norway; 2Faculty of Medicine and Dentistry, Department of Public Health and Primary Care, University of Bergen, Norway; 3Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, NorwayObjective: The aim of this study was to explore grief caused by chronic pain and treatment adherence, and how these experiences are integrated into ongoing life stories.Methods: A 6-year follow-up using a qualitative mixed-methods design based on written narratives and image narratives was performed. Five women suffering from chronic pain comprised the purposive sample. They had completed an 8-week group pain-management program with two follow-ups, and thereafter continued as a self-help group. A narrative approach was used to analyze the written and image narratives guided by three analytic steps.Results: Findings showed that experiences of grief over time were commonly associated with chronic pain. The participants' past experiences reflected their grief at having to abandon jobs and social networks, and revealed loneliness and despair. The present life situation seemed to reflect adaptation, and hope for the future had been established. Overall, forward progression means an ongoing struggle towards a reintegrated body and a meaningful life.Conclusion: Through such narratives, health-care workers can identify treatment adherence related to grief and pain, and learn how people might regain their lives beyond using traditional interviews.Keywords: chronic pain, follow-up, grief, image, narrative, nursing