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Brenda C Lovette,1,2 Sarah M Bannon,2,3 Daphne Catherine Spyropoulos,4 Ana-Maria Vranceanu,2,3 Jonathan Greenberg2,3 1Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA; 2Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; 3Department of Psychiatry, Harvard Medical School, Boston, MA, USA; 4Graduate School of Education, Fordham University, New York, NY, USACorrespondence: Jonathan Greenberg, Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA, Email jgreenberg5@mgh.harvard.eduObjective: Chronic orofacial pain is prevalent and debilitating. Psychological and social factors place a heavy burden on this population but are often overlooked. Here, we offer the first comprehensive qualitative conceptualization of the challenges of living with chronic orofacial pain through a biopsychosocial perspective to inform multifaceted care for this population.Design: We employed a qualitative thematic analysis of open text responses using a hybrid inductive-deductive approach and a biopsychosocial framework.Methods: Two hundred and sixty participants with chronic orofacial pain responded to an open-ended question: “What is the biggest challenge you face in managing your condition?” by typing their responses into a text box as part of an online survey. We mapped responses onto biomedical, psychological, and social themes (deductive) and concurrently identified findings within each theme that emerged directly from the data (inductive).Results: Subthemes within the biomedical theme included challenges with biomedical pain management, medication side effects, sensory triggers, physical symptoms of stress/tension, and biological functions and related activities of daily living. Subthemes within the psychological theme included anxiety, depression, emotional symptoms of stress, unpredictability/uncertainty of pain, and psychological and cognitive aspects of medication management. Subthemes within the social theme included social relational, experience with providers, socioeconomics and access to care, and roles and responsibilities.Conclusion: Chronic orofacial pain is associated with multifaceted challenges. Consideration of individuals’ experiences of biomedical, psychological, and social challenges in the assessment, referral, and treatment of chronic orofacial pain holds the potential to promote more comprehensive, patient-centered care for this population.Keywords: chronic orofacial pain, biopsychosocial model, qualitative research, thematic analysis |
