The doctor–patient relationship and patient resilience in chronic pain: A qualitative approach to patients’ perspectives

• Published in: Chronic illness 2018-12, Vol.14 (4), p.256-270
• Main Authors: Náfrádi, Lilla, Kostova, Zlatina, Nakamoto, Kent, Schulz, Peter J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Chronic pain; Chronic Pain - psychology; Clinical outcomes; Coping; Disease management; Female; Health literacy; Health promotion; Health status; Humans; Male; Mental health; Middle Aged; Pain; Pain Management - psychology; Patient communication; Patient Participation - psychology; Patient-centered care; Patients; Physician patient relationships; Physician-Patient Relations; Qualitative Research; Resilience; Resilience, Psychological
• ISSN: 1742-3953; 1745-9206
• DOI: 10.1177/1742395317739961

Objectives To study patients’ perspectives about the role of the doctor–patient relationship in promoting the resilience process. Methods We conducted in-depth interviews with 20 chronic pain patients. Using open-ended questions, the interviews explored aspects of the doctor–patient relationship that impacted the patients’ perceptions of their resilience. Thematic analysis built on an inductive, adaptive approach to data coding was employed to organize a representation of key factors affecting resilience. Results The themes emerging from the interviews inform us about how the different aspects of the doctor–patient relationship can promote patient resilience in chronic pain. Three main themes emerged: the doctor providing psychological support, promoting patients’ health literacy related to chronic pain and its treatment, and empowering the patients to cooperate in finding the right treatment. This fosters patients’ direct outcomes (feeling validated, health literate, and empowered), which, in turn, lead to adaptive coping responses and day-to-day disease management. These direct outcomes are crucial for patients to maintain socially and personally meaningful activities and their functional (physical) capacity. Discussion A doctor–patient relationship following the precepts of the patient-centered care is a significant resource that can lead to increased patient resilience. Thus, future interventions promoting patient resilience might consider addressing the doctor–patient relationship.