Extending the boundaries of care: Collaboratively planning connections between rehabilitation and community resources for chronic pain self-management

BACKGROUND: Linkages (i.e. partnerships or referral pathways) between chronic pain management services and community resources can strengthen the continuum of care and address unmet needs, although implementing these connections is challenging. AIMS: The aim of this study was to conduct exploratory, strategic planning to inform linkages between pain self-management within multidisciplinary rehabilitation and community resources that support the quality of life of individuals with chronic pain. 

METHODS: Using a participatory design, the deliberative dialogue methodology actively engaged individuals living with chronic pain (n = 2), health care professionals (n = 3), and researchers (n = 2) in a collaborative planning process guided by the 

PRECEDE-PROCEED model. The dialogic data were analyzed repeatedly, with synthesis within the sessions followed by two cycles of inductive and deductive coding. 

RESULTS: Following the adapted PRECEDE-PROCEED model, community linkages were guided by the goal for individuals living with pain to stay active socially, mentally, and physically, noting an environment lacking affordable, adapted resources. Participants identified linkage strategies to address predisposing (e.g. knowledge of resources), reinforcing (e.g. support of influential individuals), or enabling (e.g. accessibility) factors to promote a change in behavior and environment. Relevant community resources were described across the social determinants of health, reflecting access to necessary services (e.g. financial support, food banks, community-based health services) and engagement in meaningful activities (e.g. adapted exercise, recreation, peer support, and active listening groups). 

CONCLUSIONS: This study provides methodological, theoretical, and actionable contributions to help co-develop linkages between rehabilitation-based pain self-management and community resources for comprehensive, equity-oriented care that reflects the multidimensional experience of living with chronic pain.