Background

Self-management strategies are considered a necessary component of chronic musculoskeletal pain management to address ongoing symptoms and challenges. However uptake of self-management can be impeded by a number of factors.

Objectives

The aim of this study was to explore common impeding and facilitating factors of self-management strategies from the patient perspective.

Methods

An electronic search was performed between 2009 to May 2020 for the following databases: MEDLINE, AMED, PsychINFO, Cochrane Library, PubMed, CINAHL, PEDro, and Google Scholar. The search terms included peer-reviewed qualitative or mixed-method studies investigating the perspective of chronic musculoskeletal pain patients in regards to the use of self-management strategies. Study rigor and bias was assessed using the CASP (Critical Appraisal Skills Programme) questionnaire specific to qualitative studies. Qualitative data was coded using a three-stage thematic synthesis process. Confidence in findings was assessed using CERQual (The Confidence in the Evidence from Review of Qualitative Research).

Results

Twenty-seven studies were included with 487 participants. Six major themes were identified and divided into external and internal influencing factors. The external influencing factors were made up of the following three themes: health care practitioner role, supportive environment, accessibility. While the three internal influencing themes were: physical factors, knowledge and understanding, and psychological factors.

Conclusion

Learning to self-manage for patients in chronic pain required ongoing support either from healthcare practitioners or from social circles. To further assist the self-management process practitioners can improve self-efficacy through increasing patient knowledge of chronic pain, utilising goal setting and finding ways an individual can access ongoing support, either from the practitioner or through group programs.

中文翻译：

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成人慢性肌肉骨骼疼痛自我管理的常见障碍和促进因素：定性研究的系统评价

背景

自我管理策略被认为是慢性肌肉骨骼疼痛管理的必要组成部分，以应对持续的症状和挑战。然而，自我管理的采用可能会受到多种因素的阻碍。

目标

本研究的目的是从患者的角度探讨自我管理策略的常见阻碍和促进因素。

方法

2009 年至 2020 年 5 月期间对以下数据库进行了电子搜索：MEDLINE、AMED、PsychINFO、Cochrane Library、PubMed、CINAHL、PEDro 和 Google Scholar。搜索词包括同行评审的定性或混合方法研究，调查慢性肌肉骨骼疼痛患者在使用自我管理策略方面的观点。使用特定于定性研究的 CASP（关键评估技能计划）问卷评估研究的严谨性和偏见。定性数据采用三阶段专题综合过程进行编码。使用 CERQual（来自定性研究审查的证据的信心）评估对结果的信心。

结果

27 项研究包括 487 名参与者。确定了六个主要主题，并将其分为外部和内部影响因素。外部影响因素由以下三个主题组成：医疗保健从业者的角色、支持性环境、可及性。而影响内在的三个主题是：物理因素、知识和理解、心理因素。

结论

学习自我管理慢性疼痛患者需要医疗保健从业者或社交圈的持续支持。为了进一步协助自我管理过程，从业者可以通过增加患者对慢性疼痛的知识、利用目标设定和寻找个人可以从从业者或通过小组计划获得持续支持的方式来提高自我效能。