Interpretative phenomenological analysis of chronic pain.

OBJECTIVE: In France, chronic pain prevalence, causing professional or domestic activity restriction, increases with age, and reaches more than 60% people over 85 years old. In 2006, 40% of patients suffering from chronic pain are still not satisfied with practioners' monitoring and therefore multiply consultations. The aim of this study was to analyse the phenomenon of chronic pain, thanks to patients' experience and consciousness of their own situations.

MATERIAL/PATIENTS AND METHODS: This qualitative phenomenological study had the objective to enter in patients' "singular universe" by using two-fold hermeneutics, both empathic and critical. The interview guidelines tackled patients' experience of the disease and their expectations about the multiple doctors they had met. The analysis followed an iterative and inductive process (uncontextualisation-recontextualisation). The internal validity has been guaranteed by an independent double analysis.

RESULTS: Fifteen different interviews, lasting from 36 to 64minutes, were done in the period between September 2012 and December 2014. Patients told "a before and an after" chronic pain. They did not want "to be a charge to their relatives" but also wanted "to be recognized". The loss of his prior condition falls within the context of a therapeutic path, geared towards the search for confidence, empathy but also of a precise diagnosis and an efficient treatment. Disappointments can get patients close to look for alternative therapies.

DISCUSSION/CONCLUSION: The ambivalence of the patient, the impotence felt by the physician shakes the relationship. The narration contextualizes the painful complaint. It may be therapeutic. Unrolling his life story the patient can understand the intervention of other determinants in his suffering.