Living with pain-a systematic review on patients' subjective experiences.

Abstract

Background: Understanding the subjective experiences of patients living with chronic, acute, and cancer pain can significantly enhance the selection of treatment approaches, care, and support, ultimately improving their quality of life. This qualitative systematic review aimed to analyze if the patients' subjective experiences of living with pain differ between acute, chronic, and cancer pain states.

Methods: After registration in PROSPERO (CRD42023491745), an electronic search was conducted in the databases Medline (Ovid), Embase (embase.com), Cochrane (Wiley), Web of Science (Clarivate Analytics), and CINAHL (EBSCO) from their inception to 19 April 2024. Out of 8443 articles, 62 articles were included. The inclusion criteria that were applied were as follows: (1) participants aged 18 or older; and (2) participants' subjective experiences of chronic, acute, or cancer pain. The exclusion criteria were as follows: (a) studies presented in other languages than English, Spanish, Portuguese, Greek, and Scandinavian languages; (b) editorials, letters, legal cases, case series, and case-control studies; (c) studies and articles based on duplicated data; (d) study population with ages below 18 years. Forty-four articles regarding chronic pain, thirteen regarding cancer pain, and five regarding acute pain were included. Methodological limitations were assessed using the CASP tool for quality appraisal in qualitative evidence synthesis. Certainty of evidence was assessed with GRADE-CERQual. All included studies showed moderate (n = 18) to high (n = 44) confidence.

Results: Based on the qualitative synthesis in GRADE-CERQual, four main themes were identified: (1) impact of pain on social life, work life, and family life; (2) challenges in healthcare access; (3) psychological impact and emotional struggles from pain; and (4) barriers to effective pain management.

Conclusions: Taken together, patients with chronic, acute, or cancer pain face challenges in social, work, and personal lives. They often lack recognition and support from healthcare providers, relying on self-managed methods and facing barriers to effective management. Therefore, future research examining how the different pain types affect the lives of the patients and at the same time exploring personalized and collaborative treatment approaches is warranted. In conclusion, patients' experiences of living with pain remain unexplored in clinical practice. Understanding the impact of various pain types on mental health, self-esteem, daily life, and relationships is crucial. Also, how personalized treatments, collaborative healthcare access, and long-term management strategies can improve quality of life for patients living with pain.

Systemic review registration: PROSPERO CRD42023491745.