Pain from the inside : understanding the theoretical underpinning of person-centered care delivered by pain teams

Chronic back pain is globally acknowledged as a common reason why people seek help from health professionals. The complexity of persistent chronic pain can undermine the person’s self-esteem and present a number of challenges to an individual’s ability to manage their pain. Multi-professional person-centered care is advocated as a key strategy to support people with chronic back pain. However, the impact of these approaches on restoring the person’s independence is unclear, and little is known about whether and how person-centered approaches restore autonomy and influence the person’s ability to manage their pain. The aim of this grounded theory study was to generate understanding about person-centered care from the perspectives of people with chronic back pain and the multi-professional teams who cared for them. Semi-structured interviews were used to collect data from 17 people with chronic back pain over one year. A constant comparative analytical approach identified five key categories: the skeptical professional, validation, becoming a person, regaining control, and restoring faith. These categories formed the ‘‘conditional partnership’’ as a theory to explain person-centered care, which related to the way in which the partnership developed between the patients and teams. The findings suggest that person-centered care was influenced by the participants’ need to be believed and the relationship developed with health care providers. Crucially, these findings suggest that legitimizing the pain experience through personcentered approaches to care can empower people with chronic back pain to regain control of their lives and their pain.