Fresh eyes, clear voices: A novice investigator’s insights from interviewing patients with chronic pain

Background and context: Typically, the ability to deliver effective pain management becomes easier with greater experience. However, with greater experience, professionals may become accustomed to presentations they regularly witness, potentially resulting in more efficient and focused consultations which may inadvertently quiet the patient’s unique voice. For chronic pain patients, their lived experience is an important factor in defining the extent of their illness, which may be better understood when their voice is validated and heard. Reflecting on my personal journey as a research assistant with limited exposure to chronic pain, I have realised the benefits of approaching patients with a fresh perspective. Routine patient interviews became genuine conversations, where unique patient voices were cultivated to enrich my development of a patient-oriented understanding of chronic pain.
Process: I worked on a research project regarding the effectiveness of an introductory group pain education session run by the Flinders Medical Centre Pain Management Unit. As a medical student working as a research assistant, I conducted 19 semi-structured telephone interviews with patients who had attended, and 7 interviews with those who had failed to attend. Around the set questions, I engaged in active listening, expanded on unexpected findings and critically reflected on these interviews, identifying common themes as part of the broader investigation.
Analysis: A surprisingly recurrent theme was the gratitude from patients for the opportunity to provide personal feedback based on their individual experiences. Despite expecting a degree of hostility from those who had failed to attend, all were excited to participate, viewing this as an opportunity to help improve the experience of pain management for their peers in future.
It was evident that the majority of patients were in the pre-contemplative or contemplative stages of change: aware of the need for change, but only passively involved in their management. For these patients, many expressed the desire for the service to continually reach out, remind and encourage participants to attend. This became apparent as many suggested that speaking to me had made them more inclined to interact with the unit in future.
Outcomes: While it is commonplace to track efficacy of healthcare delivery through patient surveys and questionnaires, specific and limited questioning can unintentionally miss important unexpected issues. Given the open nature of the interviews and my lack of preconceived ideas about patient responses, patients could direct exactly how they wanted their feedback to be heard. This unearthed unexpected themes around the importance of human interactions and ensuring patients with chronic pain feel heard.
Ultimately, the patient is an expert and through listening to their lived experience, we can better understand chronic pain and reduce the risk of becoming desensitised to individual idiosyncrasies in pain stories.