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How do people with chronically painful joint hypermobility syndrome make decisions about activity?

Schmidt, A; Corcoran, K; Grahame, R; de C Williams, AC; (2015) How do people with chronically painful joint hypermobility syndrome make decisions about activity? British Journal of Pain , 9 (3) pp. 157-166. 10.1177/2049463714554112. Green open access

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Abstract

Background:The model of activity avoidance prompted by fear of increased pain and/or harm dominates understanding and research into activity limitation in chronic pain. Yet the accounts of people with chronic pain on decisions about activity limitation are rarely heard beyond the confines of fear and avoidance questionnaires. Methods We used semi-structured interviews to explore the decisions of 11 women attending a pain management clinic with chronically painful Joint Hypermobility Syndrome (JHS). Results Six themes emerged from Interpretative Phenomenological Analysis: the overall aim of keeping pain to a manageable level; considering whether the planned activity was worth it; and running through all judgements, the influence of pain intensity. The decision was tipped towards avoidance by unpredictability of pain and by high emotional cost and towards going ahead with the activity by the wish to exert control and by low emotional cost. Many accounts described a specifiable cost-benefit analysis of individual decisions, weighing the importance of each activity against its potential aversive consequences, which only in a minority of cases was dominated by fear of pain or injury. Conclusions Assumptions of fear as the basis of activity avoidance should not be used uncritically in clinical settings. Decisions about activity should explore beyond pain expectancy, incorporating goals, values, and decision processes.

Type: Article
Title: How do people with chronically painful joint hypermobility syndrome make decisions about activity?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/2049463714554112
Publisher version: http://dx.doi.org/10.1177/2049463714554112
Language: English
Keywords: Chronic Pain, Fear, Avoidance, Disability, Musculoskeletal Pain
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1473417
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