Background and aims
Psychological factors surrounding spinal cord stimulation (SCS) are commonly investigated using questionnaires, although the information provided by these is limited. The aim of this study was to explore psychological factors influencing the experience and outcome of SCS through a qualitative approach.
Methods
Semi structured interviews were carried out 1 year post SCS implantation. Thirteen participants (6 male, 7 female) were recruited via a pain management clinic. Eight participants reported >50% pain relief, 5 <50%. Interviews were recorded and transcribed verbatim. Thematic analysis was carried out by 2 independent researchers.
Results
Two core themes emerged: coping and pain, and SCS treatment Coping and pain included feelings of helplessness, being controlled by pain, frustration and anger, responsibility for pain relief and acceptance of pain. Maladaptive coping strategies including helplessness and activity avoidance in response to pain were described almost unanimously.
SCS treatment described information provision, a desire for expert patients, independence/regaining control and unexpected experiences (body image and SCS trial). SCS trial was associated with feelings around a lack of recognition for the uncomfortable experience encountered.
Conclusion
This study provides a context for understanding the experience of SCS from the patient’s perspective. In addition the findings contribute to the practical implications for preparation for SCS. Although SCS was described in relation to regaining independence and control, other aspects: access to information, expert patients, health professional relationships and uncomfortable SCS trial alongside body image factors need further consideration when preparing patients for SCS therapy.
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