Patients’ and Family Members’ Experiences of a Novel Nurse-Led Intervention Using Family Conversations Targeting Families Afflicted by Chronic Non-Cancer Pain

Abstract

Purpose

To explore patients’ and family members’ experiences of participating in an intervention using nurse-led family nursing conversations (NLFCs) targeting families affected by chronic non-cancer pain (CNCP), including the perceived impact of the intervention on the individual and the family. CNCP substantially impacts patients and families. Due to a lack of simple treatment solutions, the condition needs to be managed rather than cured. Family involvement seems a promising tool, but research evaluating specific approaches is limited. Interventions based on the family systems nursing framework by Wright and Leahey have been helpful in other populations. Nonetheless, the approach warrants further investigation and evaluation in patients with CNCP.

Patients and Methods

A phenomenological hermeneutical design was applied, and individual interviews were conducted with ten patients and ten family members who received the intervention. The analysis was inspired by Ricoeur’s philosophy of text interpretation.

Findings

Three themes emerged during the analysis. “Taking part in the intervention while being affected by previous experiences” showed that patients and family members were affected by different experiences and burdens and therefore entered the intervention with varied starting points. “Being empowered through validation and understanding” showed that participants mainly viewed the intervention as beneficial, increasing patients’ and family members’ mutual understanding and underpinning acceptance of the chronic pain condition. “Being receptive to the intervention – mechanisms contributing to achieving benefit” identified contributing mechanisms influencing patients’ and family members’ experiences of the intervention. These mechanisms included confidence in the nurses’ facilitation of the intervention, the timing of the intervention, the participant’s level of acceptance, and readiness to engage in the intervention.

Conclusion and Relevance to Clinical Practice

The intervention was mainly experienced as helpful. Thus, healthcare settings treating CNCP should consider implementing NLFC in clinical practice with adjustments to meet the vulnerability of the CNCP population.

Keywords:

• family involvement
• family systems nursing
• qualitative
• phenomenological hermeneutics
• Ricoeur

Abbreviations

CNCP, Chronic non-cancer pain; CRPS, Complex regional pain syndrome; FANCOC-PAIN, FAmily Nursing COnversations Chronic non-cancer PAIN; NLFC, Nurse-led family nursing conversation; ICD-11, The 11th International Classification of Diseases; MPC, Multidisciplinary pain center.

Data Sharing Statement

Data are not publicly available due to the General Data Protection Regulations. Requests may be directed to the corresponding author.

Ethical Approval and Informed Consent

The study complied with the ethical guidelines of the Declaration of Helsinki.⁵⁰ The Danish Committee on Health Research Ethics waived the requirement for notification of the study, which was registered with record no: H-19016896. The Danish Data Protection Agency registered the study with record no. P-2019-508. Eligible patients who consented were contacted by the first author face-to-face or by telephone. Patients and family members interested in participating in the NLFC intervention received written and oral information about the quasi-experimental trial and the present study. The verbal information about the present study was repeated to those who were enrolled after the completion of the last NLFC with an invitation to participate in an interview. Patients and family members were informed that their participation was voluntary and that they could withdraw their consent anytime without explanation or treatment consequences. The interview data were anonymized during transcription, analysis, and reporting of the results. Oral and written consent was obtained. The informed consent included the publication of anonymized responses. The reporting followed the consolidated criteria for reporting qualitative research.⁵¹

Consent for Publication

Written consents are available.

Acknowledgments

We are deeply grateful to the patients and family members who participated in the intervention and agreed to be interviewed. We thank the MPC, the CRPS clinic, and the Department of Anaesthesia, Pain, and Respiratory Support for continuous support and hosting of the project.

Author Contributions

All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure

The authors have no conflicts of interest in this work.

Additional information

Funding

The study was supported by the Dagmar Marshalls Foundation [J.nr. 500020]; Danish Nurses Organization; Danish Nurses Organizations Nursing Research Foundation and Novo Nordisk Foundation [NNF21OC0072540].