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Exploring the Meaning and Experience of Chronic Pain with People Who Live with a Dog: A Qualitative Study

September 2018
Anthrozoös 31(5):551-565

DOI:10.1080/08927936.2018.1505267

Authors:

Eloise CJ Carr

The University of Calgary

Jean Elizabeth Wallace

The University of Calgary

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Pain is a significant burden for those with chronic disease and negatively impacts quality of life, causing disability and substantial work and health-care costs. Chronic pain has been identified as one of the most important current and future causes of morbidity and disability across the world. Living with a dog has been associated with greater physical activity, less disability, more social ties to the community, and improved mental health. In this study, we sought answers to the research question, “What is the meaning and experience of chronic pain for people who live with a dog?” Using a descriptive qualitative research design, we conducted telephone interviews with 12 patients who lived with a dog, attending a tertiary chronic pain program in western Canada. Transcribed interviews were subject to thematic and interpretive analysis. Participants ranged in age from 39 to 70 years of age (average 54 years) and had experienced chronic pain for an average of 15 years. The analysis identified four themes that gave under-standing as to how people who live with a dog experience chronic pain: dog gives life meaning; dog as caregiver; dog gives emotional support; and dog provides companionship. For those experiencing chronic pain, living with a dog was reported to positively impact their quality of life, mental wellbeing, physical activity, and social interaction. For some participants, living with a dog provided a reason to live and focus on the future. For people with chronic pain, living with a dog may enhance the quality of their lives and provide support that mitigates their suffering and enables them to live a more meaningful life.

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Anthrozoös

A multidisciplinary journal of the interactions of people and animals

ISSN: 0892-7936 (Print) 1753-0377 (Online) Journal homepage: http://www.tandfonline.com/loi/rfan20

Exploring the Meaning and Experience of

Chronic Pain with People Who Live with a Dog: A

Qualitative Study

Eloise C. J. Carr, Jean E. Wallace, Chie Onyewuchi, Peter W. Hellyer & Lori

Kogan

To cite this article: Eloise C. J. Carr, Jean E. Wallace, Chie Onyewuchi, Peter W. Hellyer & Lori

Kogan (2018) Exploring the Meaning and Experience of Chronic Pain with People Who Live with a

Dog: A Qualitative Study, Anthrozoös, 31:5, 551-565, DOI: 10.1080/08927936.2018.1505267

To link to this article: https://doi.org/10.1080/08927936.2018.1505267

Published online: 19 Sep 2018.

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    

   

 

Address for correspondence:

Eloise C. J. Carr,

Faculty of Nursing,

Professional Faculties

Building,

University of Calgary,

2500 University Drive NW,

Calgary, Alberta, Canada

T2N 1N4.

E-mail: ecarr@ucalgary.ca

551 

Exploring the Meaning and

Experience of Chronic Pain

with People Who Live with

a Dog: A Qualitative Study





*Faculty of Nursing, Department of Community Health Sciences,

University of Calgary, Calgary, Alberta, Canada

†Department of Sociology, Faculty of Arts, University of Calgary,

Calgary, Alberta, Canada

‡Department of Clinical Sciences, College of Veterinary Medicine &

Biomedical Sciences, Colorado State University, Fort Collins,

Colorado, USA

ABSTRACT 





       



   





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













     

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



















Study Design





 

















Sample











 



553 

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



Data Collection



















Telephone Interviews





















Data Analysis

















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

























Dog Gives Life Meaning















    





























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

























Dog as Caregiver



































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Dog Gives Emotional Support

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

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

Dog Provides Companionship



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



         



      







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





    

    





            



Future Directions













   

















Limitations













  



















              

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

















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 







Anthrozoös, 26





PLoS ONE, 10

  

Anthrozoös, 28

Qualitative Research in Psychology, 3,





Canadian Journal of Pain, 1

Nursing Times Research, 6,

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

BMJ, 357



American Journal of Lifestyle

Medicine, 12



        Anthrozoös, 27  





 International Journal of Evidence Based Healthcare, 8







Physical & Occupational Therapy in Geriatrics, 31

 Research design: Qualitative, quantitative and mixed methods approaches 

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 Best practices for mixed methods

research in the health sciences. Retrieved from National Institutes of Health:





     International Journal of Nursing Studies, 68, 



Anaesthesia & Intensive Care Medicine, 17





       Patient Education & Counselling, 100 





SAGE Open, 4

              

Neuroscience Letters, 520



 International Journal of Qualitative Methods, 5

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

 Health Services Research, 48, 



Pain Medicine, 12, 



Veterinary Clinics

of North America Small Animal Practice, 39





           Lancet, 386, 





     British Medical Journal, 334,  



            Educational

Communication and Technology Journal, 29



Field Methods, 18



Pain Research & Management, 9



Social Indicators Research, 80

 British

Journal of Anaesthesia, 111

    

Headache, 34

              

Inquiry, 54









Animal Frontiers, 4, 



Sociology Compass, 11, 

Journal of Advanced Nursing, 19,

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Generations, 17



           Pain, 136,  



Western

Journal of Nursing Research, 37



  

Pain Research & Management, 12

Current Pain Headache Research, 17





        Pain Medicine, 13  





     Anthrozoös, 28  





         British Medical Journal, 331 





 Classification of chronic pain  



 Qualitative data analysis : A methods sourcebook 





International Journal of Qualitative Methods, 1

Evidence Based Nursing,

18



Quality of Life Research, 22, 

   

Journal of Mixed Methods Research, 4



             

Anthrozoös, 30



    Canadian Journal of Anaesthesia, 54 





Health policy perspectives on chronic pain



Porto Biomedical Journal, 2







 Pain Research & Management, 17

 Pain, 157





       SAGE Open Medicine, 2. 



Pain Research &

Management, 16

Pain Research & Management, 16

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

       Psychology & Health, 27, 



American Scientist, 100



Popululation Health

Management, 20. 



      Annals of Palliative Medicine, 6 





Clinical Medicine, 2, 







Health Services and Delivery Research, 2



 Journal of the American

Geriatric Society, 54



Pain Medicine, 10



British Journal of General

Practice, 63

                

Psychological approaches to pain management 

        Family

Processes, 48, 

   

 International Journal of Behavioural Medicine, 15



Social

Science & Medicine, 61





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565 

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Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department

Article

Full-text available

Mar 2022
PLOS ONE

Context Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern. Objectives Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain. Design, setting and participants Using a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,). Intervention 10 minute therapy dog team visit in addition to usual care. Main outcome measures Change in reported pain from pre and post therapy dog team visit and comparison with a control group. Results A two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean change int. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], η p ² = 04) but not the control group. Anxiety (mean change int. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], η p ² = .04), depression (mean change int. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp ² = .047), and well-being ratings (mean change int. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp ² = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%). Conclusions Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients’ experience of pain, and related measures of anxiety, depression and well-being. Trial registration This controlled clinical trial is registered with ClinicalTrials.gov, registration number NCT04727749 .

Understanding the impact of dog ownership on autistic adults: implications for mental health and suicide prevention

Article

Full-text available

Dec 2021

Mental health problems and suicide are more frequent in autistic adults than general population. Dog ownership can improve human well-being. This study aimed to generate a framework of well-being outcomes for dog-related activities in autistic adults and compare it to the framework generated for a general adult population. Thirty-six autistic dog owners (18–74 years old, 18 males) from diverse UK regions were interviewed and transcripts thematically analysed. 16.7% reported that their dogs prevented them from taking their own lives, mainly due to the dog's affection and the need to care for the animal. Close dog-owner interactions (e.g., cuddling, walking, dog's presence) were the most frequent activities improving emotions/moods and life functioning, whereas routine-like activities (e.g., feeding the animal) particularly enhanced life functioning. Well-being worsening was mainly linked to dog behaviour problems, dog poor health/death and obligations to the dog. Despite some negatives associated with ownership, having a dog could improve the well-being of many autistic adults and assist suicide prevention strategies in this high-risk group. The framework was consistent with that generated previously, indicating its robustness and the potential opportunity to focus on dog-related activities rather than the vague concept of “ownership” when considering the impact of ownership on well-being.

Theoretical Foundations to the Impact of Dog-Related Activities on Human Hedonic Well-Being, Life Satisfaction and Eudaimonic Well-Being

Article

Full-text available

Nov 2021
Int J Environ Res Publ Health

Cross-sectional comparisons of well-being between dog owners and non-owners commonly generate inconsistent results. Focusing on the uniqueness of the relationship might help address this issue and provide a stronger foundation for dog-related psychotherapeutic interventions. This study aims to evaluate the impact of dog-related activities (e.g., exercising the dog) on owner hedonic well-being, life satisfaction and eudaimonic well-being. It was also hypothesised that psychological closeness to the dog would affect these well-being outcomes. For this study, 1030 dog owners aged over 18 years old answered an online questionnaire about the impact of 15 groups of dog-related activities on their well-being. Ordinal regressions were used to estimate the mean response (and its uncertainty) for each outcome, while conditioning for psychological closeness to the dog and controlling for several key covariates. Tactile interactions and dog playing were significantly more beneficial than other activities for hedonic well-being, and dog training and dog presence for eudaimonic well-being. In contrast, dog health issues and behavioural problems were linked to decrements in these well-being outcomes. Higher psychological closeness to the dog predicted greater improvement in well-being in positive dog-related activities. Our quantitative study validates the general findings of previous qualitative work and lays the groundwork for future longitudinal studies.

Affordability, Feasibility, and Accessibility: Companion Animal Guardians with (Dis)Abilities’ Access to Veterinary Medical and Behavioral Services during COVID-19

Article

Full-text available

Aug 2021

The research aims to explore COVID-19 health and safety protocol impacts on companion animal guardians living with (dis)abilities relating to veterinary medical and behavioral service access. The COVID-19 global public health crisis has impacted almost all international communities; however, vulnerable and marginalized groups have been disproportionately affected. Within the human–companion animal domain, COVID-19-driven societal impacts (e.g., social, health, and economic) not only boomed with new companion animal guardians, but also negatively influenced guardians’ access to veterinary services. Although studies have examined guardian-related COVID-19-specific challenges, there is a paucity of concentration on vulnerable populations, such as persons with disabilities (PWDs). Responding to this research deficit, this study recruited twelve companion animal guardians to participate in semi-structured in-depth interviews, and eight (67%) of the twelve participants self-identified as PWDs. From a PWD perspective, this research reveals three pandemic-triggered primary barriers, preventing PWDs from pursuing veterinary services: (1) service affordability, (2) assistance program feasibility, and (3) veterinary service accessibility. This article argues that PWD-driven approaches could improve existing assistance and support programs to address PWDs’ unique requirements, promoting a healthy human–animal bond.

The Impact of the Social Determinants of Human Health on Companion Animal Welfare

Article

Full-text available

Mar 2023

The social determinants of health (SDH) focus on the social, physical and economic factors that impact human health. Studies have revealed that animal guardians face a range of challenges in attaining positive welfare outcomes for their companion animals, which can be influenced by socioeconomic and environmental factors. Despite this, there is a lack of research specifically exploring the relationship between SDH and animal welfare outcomes. Given that the SDH impact on humans, which in turn directly impacts on their companion animal, it is important to adapt an SDH framework for companion animal welfare by characterising the impact of the SDH on companion animal guardians in their attempts to care for their animals and, by extension, the associated welfare outcomes. This paper explores how these human health determinants may impact animal welfare and the possible challenges that may arise for the guardian when attempting to meet their companion animal’s welfare needs. By integrating the SDH with other key frameworks, including the five domains model of animal welfare, through multidisciplinary collaboration, this framework can be used to inform future programs aiming to improve animal welfare.

A randomized trial of differential effectiveness of service dog pairing to improve quality of life for veterans with PTSD

Article

Jan 2020

Full text available from: https://www.research.va.gov/REPORT-Study-of-Costs-and-Benefits-Associated-with-the-Use-of-Service-Dogs-Monograph1.pdf Objectives. Determine whether overall disability and quality of life of Veteran participants in treatment for PTSD are improved by the provision of service dogs relative to provision of emotional support dogs. Design. Multicenter parallel, two-arm, randomized clinical trial with Veteran participants diagnosed with PTSD assigned 1:1 to either a service dog or an emotional support dog. Randomization was conducted centrally by the study coordinating center using the computer-generated Interactive Touch Tone Randomization System (ITTRS). Setting. Three VA medical centers: Atlanta VA Medical Center (Atlanta, GA) Iowa City Veterans Affairs Health Care System (Iowa City, IA), and VA Portland Health Care System (Portland, OR). Participants. 227 Veteran participants were randomized and fulfilled study requirements, of which 181 were paired with a study dog. Intervention. After randomization to either the service dog intervention or emotional support dog intervention, an observation period of at least three months duration began; during this period both the study team and the participants were blinded to the type of dog to which the participant had been randomized. Dog type assignment disclosure to the participant and the study team occurred upon completion of the observation period. Participants were paired with either service dogs or emotional support dogs per assignment and followed for 18 months. Main outcome measures. Overall disability (WHO-DAS 2.0) and quality of life (VR-12). Secondary outcomes included PTSD symptoms (PCL-5), suicidal ideation (C-SSRS), depression (PHQ-9), sleep (PSQI) and anger (DAR). Results. 227 participants were randomized to either the service dog intervention (n=114) or emotional support dog (n=113) intervention. 46 participants terminated prior to pairing; (n=17) participants assigned to the service dog intervention versus (n=29) participants assigned to the emotional support dog intervention. 97 participants were paired with a service dog; 84 participants were paired with an emotional support dog. 9 participants paired with a service dog terminated after pairing; 19 participants paired with an emotional support dog terminated after pairing. Participants paired with a dog were on average 50.6 years old (SD=13.6; range 22-79), mostly male (80.1%), white (66.3%), and non-Hispanic (91.2%). After adjusting for baseline score, center, and gender, the linear mixed repeated measures (LMRM) model for WHO-DAS 2.0 (disability) showed no statistical difference between the two intervention groups nor did the mixed models for quality of life (VR-12) show statistical differences between the two groups for either PCS (physical health) or MCS (mental health). Of the secondary outcome measures, only PCL-5 (PTSD symptoms) using the adjusted LRMR model showed a statistically significant difference between intervention groups. Participants receiving the service dog intervention had a 3.7-point improvement (lower score=less symptoms of PTSD) in the PCL-5 total score over time as compared to the emotional dog intervention. Contrasts testing for a difference in the service dog group versus the emotional support dog group for suicidal ideation and behavior (per C-SSRS) did not show a significant difference between groups across time, however, it did show a difference between groups at 18 months with the service dog group having fewer suicidal behaviors and ideation. In both groups, WHO-DAS 2.0 scores at 18 months decreased (less disability) from scores at 3 months post pairing; improvement in VR-12 MCS also showed some improvement over time in both groups. Descriptive statistics for sleep and anger also showed a decline in scores (improvement) over time in both groups. Serious Adverse Events (SAE) and adverse events (AE) were compared across groups. None of the SAEs in either group were dog related. All AEs occurred in the emotional support dog group. Conclusions. While both groups appeared to have experienced some benefit, an improvement in overall disability and quality of life among Veteran participants with PTSD was not observed with the provision of a service dog relative to provision of an emotional support dog. Among secondary outcome measures, participants paired with a service dog experienced a reduction in the severity of PTSD symptoms (PCL-5) compared to participants paired with an emotional support dog, and had fewer suicidal behaviors and ideations, particularly at 18 months post- pairing.

Pet Ownership and Quality of Life: A Systematic Review of the Literature

Article

Full-text available

Dec 2021

Pet ownership is the most common form of human–animal interaction, and anecdotally, pet ownership can lead to improved physical and mental health for owners. However, scant research is available validating these claims. This study aimed to review the recent peer reviewed literature to better describe the body of knowledge surrounding the relationship between pet ownership and mental health. A literature search was conducted in May 2020 using two databases to identify articles that met inclusion/exclusion criteria. After title review, abstract review, and then full article review, 54 articles were included in the final analysis. Of the 54 studies, 18 were conducted in the general population, 15 were conducted in an older adult population, eight were conducted in children and adolescents, nine focused on people with chronic disease, and four examined a specific unique population. Forty-one of the studies were cross-sectional, 11 were prospective longitudinal cohorts, and two were other study designs. For each of the articles, the impact of pet ownership on the mental health of owners was divided into four categories: positive impact (n = 17), mixed impact (n = 19), no impact (n = 13), and negative impact (n = 5). Among the reviewed articles, there was much variation in population studied and study design, and these differences make direct comparison challenging. However, when focusing on the impact of pet ownership on mental health, the results were variable and not wholly supportive of the benefit of pets on mental health. Future research should use more consistent methods across broader populations and the development of a pet-ownership survey module for use in broad, population surveys would afford a better description of the true relationship of pet ownership and mental health.

Physical Activities in Public Squares: The Impact of Companionship on Chinese Residents’ Health

Article

Full-text available

Jul 2021

Companionship is the most important social support factor in physical activities, but the influence of companionship on the daily physical activities of Chinese people in the square is not clear. The ordered logistic regression was conducted to identify the companionship and physical activities associated with the physical and mental health of residents (n = 196). The results show that companionship has direct and indirect effects on mental health, and companionship acts on physical health through physical activity in public squares. Our research understands the use of public open space (POS) from the perspective of companionship and provides a new perspective for improving the sociality of POS design.

Examining the role of pets in cancer survivors' physical and mental wellbeing Examining the role of pets in cancer survivors' physical and mental wellbeing

Article

Jun 2021
J PSYCHOSOC ONCOL

Joshua Trigg

Purpose Australian cancer survivors have multiple wellbeing support needs, and Australians frequently keep pets, a practice associated with physical and mental health benefits. This mixed-methods study explores the influence of relationships of PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) wellbeing domains and pet ownership on cancer survivors’ physical and mental wellbeing and quality of life. Methods A convenience sample of Australian cancer survivors (N = 162) were surveyed, recording demographic, pet ownership, PERMA wellbeing, physical and mental health characteristics, and support needs. Quality of life and health scores were predicted from PERMA domains and pet ownership. Results Pet ownership was highly prevalent in participating cancer survivors, predicting increased mental health scores. No associations were seen for physical health. Cancer survivors sought instrumental pet care support and pet-owner relationship maintenance during survivorship. Implications: Pet ownership may be leverageable in interventions for mental health and wellbeing improvement during cancer recovery. Research should next clarify pet ownership prevalence in this population.

A scoping review of research on human-canine interactions to reduce loneliness and promote socializing behaviors in early and middle adulthood

Article

Jan 2023

Feelings of loneliness affect emotional and physical health and wellbeing. With more individuals experiencing pervasive and chronic loneliness than ever before, strategies that reduce feelings of loneliness and promote pro-social behaviors are needed. Human-canine interactions may meet this need. The objective of this scoping review was to examine the extent, range, and nature of research activity pertaining to human-canine interactions to address loneliness and socialization in early and middle-aged adults and identify what gaps remain for future research to address. Relevant databases and journals were searched for studies on this topic. Based on inclusion criteria, 21 articles were included in the review. Findings suggest that human-canine interactions may decrease feelings of loneliness and increase socializing behaviors. However, the results are not broadly generalizable due to a lack of diverse and representative participant samples. Future research should evaluate the impacts of human-canine interactions on the feelings of loneliness and socialization on larger and more diverse populations and identify mechanisms of change.

Asking About Pets Enhances Patient Communication and Care: A Pilot Study

Article

Full-text available

Oct 2017
INQUIRY-J HEALTH CAR

This research explored whether asking patients about their pets would enable better environmental/social history taking, and improve patient communication/care. Primary health care providers (PHPs) were surveyed about prevalence of patients living with pets, the health impact of pets, and influences on patient communication. Following an educational intervention, they committed to asking patients about their pets. A follow-up survey was conducted electronically. PHPs were recruited at a continuing medical education (CME) conference and at CME workshops. All 225 participants were PHPs. At the conference, participants were educated one-on-one about the clinical relevance of pets in the family. CME sessions were large or small group teaching. Baseline and final surveys measured awareness of pets in patients’ families, assessment of determinants of health, impact on rapport with patients, and patient care. A sign test assessed difference in scores using repeated-measures analysis. Binomial outcomes were assessed using Fisher’s exact test. Comments were themed. Ninety-four PHPs (42%) completed the study. Pet-related discussions opened communication with patients. Two-thirds of participants identified positive effects on practice and on relationships with patients. PHPs were able to leverage the health benefits of pets (zooeyia) and mitigate zoonotic risk. Asking patients about pets in the family reveals clinically relevant information, improves communication, and strengthens the therapeutic alliance.

The influence of relationships on the meaning making process: Patients’ perspectives

Article

Full-text available

Jul 2017

Background: The diagnosis of a chronic or life limiting illness followed by treatment often requires an adjustment to life goals and expectations. With added existential concerns, patients' struggle to redefine life meaning while also finding ways to alleviate any distress that may occur. Central to the work of many scholars, meaning making is thought to be a vital component of negotiating traumatic life events while also essential to the positive adjustment in chronic illness and healing. Information gained from science about meaning making is an important link to the medical community as it provides physicians with insight to increase patient centered care. The purpose of this qualitative study was to expand our understanding of meaning making for an individual diagnosed with a chronic or life limiting illness. Also, to explore the connection, if any, to how meaning making may lead to an outcome of psychosocial spiritual healing or exacerbate distress. Methods: The goal of this secondary data analysis was to examine the influences of meaning making to determine its impact on a patient's sense of healing. This study utilized data collected during in-person interviews using a convenience sample of 30 palliative care patients. The original study was conducted at three different locations: the National Institutes of Health Clinical Center (NIH), a large research institution in Bethesda, Maryland; Johns Hopkins Suburban Hospital, a community hospital in Bethesda, Maryland; and Mobile Medical Care (Mobile Med), a community clinic located in Rockville, Maryland. A total of 56 potential participants were approached based on convenience sampling with 30 participants enrolled (54%). Results: The overall theme that emerged indicated a strong emphasis on meaning making through relationships, specifically an increase of meaning in family relationships, the connection to friends, and a change in compassion towards others. Conclusions: Further investigation is needed to explore relationships as a variable in finding meaning during life limiting illness among patients, loved ones and their physicians. It is clear that developing meaning is a central mechanism to the construct of healing.

The suffering of chronic pain patients on a wait list: Are they amenable to narrative therapy?

Article

Full-text available

Jul 2017

Background: Chronic pain affects one in five Canadians. People with chronic pain frequently experience loss in their lives related to work, relationships, and their independence. They may be referred to a chronic pain program, which aims to strengthen coping through medical intervention and self-management skills. Data suggest that, even when individuals begin their pain program, many feel overwhelmed and do not continue. Aims: The aim of this study was to conduct a needs assessment to explore the acceptability and feasibility of developing a psychosocial intervention, narrative therapy (NT), to address loss for chronic pain patients on the wait list of a chronic pain program. Methods: Two focus groups were conducted with ten patients who had experienced being on a wait list for a provincial chronic pain management program (CPMP). Transcribed interviews were subjected to thematic and interpretive analysis. Results: Two major themes emerged from the analysis: loss of identity and sharing a story of chronic pain. All patients were enthusiastic toward an NT intervention, although individual preferences differed regarding mode of delivery. Conclusions: Loss is a significant part of the chronic pain experience. NT seems to be an acceptable intervention to address loss for patients on the wait list for a chronic pain program.

Management of chronic pain using complementary and integrative medicine

Article

Full-text available

Apr 2017

Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronic pain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action and clinical studies on the efficacy of commonly used CIM modalities such as acupuncture, mind-body system, dietary interventions and fasting, and herbal medicine and nutrients.

Comfort, well-being and quality of life: Discussion of the diferences and similarities among the concepts

Article

Full-text available

Dec 2016

Highlights: The distinction among the concepts of comfort, well-being and QoL is often unclear.This ambiguity can lead to redundancies, gaps, and knowledge dispersion.The concepts are not surrogate terms but related concepts sharing common attributes. Aim: To analyze the differences and similarities of the concepts of comfort, well-being and quality of life (QoL). Methods: Review of concept analysis research on PubMed, Cinahl (full text) and Scielo, using the search terms "Comfort", "Well-being", "Quality of Life" and "Concept Analysis". Results: Eighteen studies were included. Comfort is a broader holistic concept while well-being is mainly related to psycho-spiritual dimensions. QoL reflects the individual perception of satisfaction with life. Conclusions: The concepts are not surrogate terms, but related concepts sharing common attributes. Caution should be taken in further research, particularly as regards the correct use and framing of the concepts.

Measuring Quality of Life in Owners of Companion Dogs: Development and Validation of a Dog Owner-specific Quality of Life Questionnaire

Article

Jan 2017

Numerous studies have examined the link between companiondog ownership and improved physical or psychological health outcomes; however, few have examined the association between dog ownership and owners’ overall wellbeing or quality of life (QOL). Moreover, the potential for dog ownership to adversely affect owner QOL has been largely ignored. In general, little is known regarding the specific aspects of QOL that are most affected by dog ownership, and there are no instruments specifically designed to assess the QOL of dog owners. If such a tool was available, these effects could be better quantified, understood, and potentially utilized to further improve owner QOL. The aim of the present study was to develop and validate a QOL questionnaire specifically suitable for use in dog owners. A literature review, focus-group activities, and expert content review were used to generate an item pool for the instrument. Both positive and negative effects of dog ownership on QOL were considered. Developmental and validation versions of a QOL instrument were tested using exploratory and confirmatory factor analysis, respectively. The validity and reliability of the QOL instrument were tested using goodness of fit indices and Cronbach’s alpha. The study produced the 10-item Dog Owner Quality Of Life Questionnaire (DOQOL) comprised of 3 different factors: emotional wellbeing, social and physical activities, and stress and responsibility of dog ownership. The factor structure had good fit and internal reliability. The DOQOL represents a suitable tool to measure QOL in dog owners, and future use could improve our understanding of the relationship between dog ownership and QOL.

More-than-human families: Pets, people, and practices in multispecies households

Article

Feb 2017

Although humans have coexisted with dogs and cats for thousands of years, that coexistence has taken on various meanings over time. Only recently have people openly included their pets as members of the family. Yet, because of the cultural ambivalence toward animals, what it means for a pet to “be” a family member remains unsettled. Drawing from research on family practices including kinship, household routines, childhood socialization, and domestic violence, this paper considers how pets participate in “doing” family and what their presence means for this social arrangement long considered quintessentially human. Today's more-than-human families represent a hybrid of relations, human and animal and social and natural, rather than an entirely new kind of family. Becoming family has always been contingent on a cast of nonhuman characters, and recognition of the “more-than-human” can enhance sociological understanding, not only of the family but also of other aspects of social life.

Biopsychosocial perspective on chronic pain

Article

Jan 1996

D.C. Turk

Older peoples' strategies for coping with chronic non-malignant pain: A qualitative meta-synthesis

Article

Dec 2016

Background: There is evidence that chronic pain is not recognised or managed effectively in older people. It is important to examine how older people cope with this because of the impact it can have on their quality of life and mortality. It will also enable nurses to work with older people to support effective coping skills and provide information on other useful coping strategies. Objectives: To examine how older people cope with non-malignant chronic pain. Design: This is a qualitative meta-synthesis using Confidence in the Evidence from Reviews of Qualitative Research developed by Grading of Recommendations Assessment Development and Evaluation working group to evaluate the strength of the evidence. Data sources: PubMed and Ovid Medline from 1995 to 2015. Review methods: Following a systematic search strategy all papers were assessed in relation to inclusion criteria and quality. Only qualitative studies were included. Themes were extracted from each study and a meta-synthesis conducted before completing an evaluation of confidence in the findings. Results: Seventeen primary studies were included in the meta-synthesis. Three meta-themes were identified: 'adjusting to the inevitable', 'doing it my way without medication' and 'the importance of support in managing the struggle'. There was high confidence in the evidence for 'doing it my way without medication' and moderate confidence in the evidence for the other two meta-themes. Conclusion: Given that the participants in the primary studies were generally wary of health professionals and stoic in their response to pain, it is important for nurses to communicate in ways that engage older people and ensure their independence and sense of control remains intact. Identification of current coping strategies will enable the nurse and the older person to work together to assess their effectiveness and to adapt these if more effective coping is required.

Best practices for mixed methods research in the health sciences

Article

Jan 2011

Exploring the Meaning and Experience of Chronic Pain with People Who Live with a Dog: A Qualitative Study

Abstract

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