The Lived Experience of Pain Services: A Comparison of Service Users' and Service Providers' Experience of Irish Health Services.

Abstract

Background: A supportive healthcare experience that implements a biopsychosocial model of care can empower a person with chronic pain to make informed decisions and engage in self-management behaviours. Despite the positive influence of supportive healthcare, little is known about the presence of healthcare support in under-resourced chronic pain services. This idiographic study explores the lived experience of service users and providers participating in chronic pain services with a specific focus on autonomy support and self-management skills. Methods: Semistructured interviews were conducted on service users (n = 7) self-reporting a diagnosis of chronic pain (pain > 3 months) and service providers (n = 5), defined as healthcare professionals with > 3 years of experience in clinical healthcare settings managing pain conditions. All interviews took place online (mean 47 ± 11 min). Interview transcripts were analysed using interpretative phenomenological analysis. Results: Analyses generated four themes: 'biomedical model leads care'; 'lost in a system'; 'I need support' and 'the essentials of self-management'. Both service users and providers described regular experiences of invalidation and biomedical approaches to pain management. Long waitlists, a lack of multidisciplinary services, short appointment times and a lack of educational resources all impacted the development of self-management skills in service users. Conclusion: Despite clinical guidelines recommending a biopsychosocial model of care, the biomedical model remains the dominant approach in chronic pain management, reflecting a persistent gap between evidence and practice. Service users and providers desire access to multidisciplinary services that support a biopsychosocial model of care. Healthcare professionals cannot deliver what service users expect due to macro-, meso- and microlevel factors. Future research is needed to explore practical solutions to deliver pain services that optimise the development of self-management skills where existing infrastructure and resources negatively impact service delivery. Suggested approaches include enhancing autonomy-supportive communication by healthcare providers and ensuring early access to high-quality educational materials.