Lived Experiences of Chronic Pain Patients Attending Follow-up Visits at a Pain Clinic During the COVID-19 Pandemic in Thailand

Abstract

Objective: The whole world stopped turning, for most countries, due to shutdowns during coronavirus pandemics, with the exception of chronic pain patients. More than 40 years of unprecedented service changes in the pain clinic, under the COVID-19 era, could cause major impacts on patients living with chronic pain. We conducted this in-depth interview to evaluate how COVID-19 affected pain in patients with chronic pain.
Material and Methods: Face-to-face, in-depth interviews with tape recordings were used to explore the informants’ perspective, so as to capture their own words, thoughts, perceptions, feelings and experiences under the COVID-19 prevention and control measures. Field-notes and detailed memos were also recorded during the interview. The key informants consisted of 17 chronic pain patients, who came for follow-up visits at the pain clinic during the third and fourth waves of the COVID-19 pandemic. The qualitative content analysis method was employed to analyze the verbatim transcription of the interview recordings to identify themes and patterns.
Results: The findings revealed the key informants viewed COVID-19 as being closely tied with the perception of to what extent it impacted on maintaining their usual pain treatment and care as accessed. The key informants’ feelings of fear and worry were not generated from the effects of COVID-19 on their physical health, but were from the healthcare services changes and restrictions they faced. The ‘new normal’; as such social distancing, was viewed as similar and congruence with their long-lasting normal lifestyles. Talking about COVID-19 is a lot less interesting without talking about pain. The key informants preferred taking the risk of catching COVID-19, rather than coming back for untreated pain. The door-to-door pain medication delivery service provided a sense of uncertainty and could not replace the therapeutic feelings of a sense of heartwarming, care and safety generated while having face-to-face meetings with a doctor as well as acts of kindness and compassion from the pain clinic staff.
Three themes emerged from the findings: 1) the COVID-19 pandemic poses a threat to perceived stability on pain control; 2) embracing the ‘new normal’ in the world of chronic pain patients; and 3) a silver lining in the midst of the COVID-19 pandemic.
Conclusion: The way patients experienced the COVID-19 pandemic well reflects individual differences in the subjective experience of pain and individual needs of chronic pain patients. Changing of healthcare services utiliza­tion at pain clinics during the COVID-19 pandemic should be therefore concerned not only with the continuum of pain treatments, but also congruent to the care needs of chronic pain patients.