Exploring the Breadth of Personal Strengths Used to Overcome Pain: A Qualitative Study of People Living Well With Pain and People Recovered From Pain.

BACKGROUND: Understanding factors protective against musculoskeletal pain is key to strengths-based pain care. Protective factors have received limited examination and appear dominated by psychosocial factors. Exploration of factors influencing recovery from pain appears lacking. OBJECTIVES: To examine the breadth of protective factors via lived experiences of people living well with pain and people recovered from pain. DESIGN: Qualitative study. METHOD: Participants self-identifying as living well with pain, or recoverees, completed semi-structured interviews (online/face-to-face) driven by indicative questions regarding protective factors. Reflexive thematic analysis derived themes/subthemes reviewed by the research team and consumers. RESULTS: Twelve people (four recoverees) participated. The "Allure of the deficits model" highlighted the need to acknowledge deficits in people with pain as strengths-based care may expected. The second theme captured strengths positively influencing physical activity including long-term habitual engagement, psychological protective effects and accepting gradual return to previous function. The importance of valued activities bringing "Flow and enjoyment" were captured in theme three. "Committed action" revealed a commitment mindset driven by personal goals. Theme five highlighted psychological factors including acceptance, flexibility, mindfulness, positive pain-related cognitions, and spirituality. Diet and sleep were "Positive lifestyle factors". Theme seven explored protective social connections and economic resources including family and community support. CONCLUSIONS: A broad range of multidimensional factors were perceived as protective. Two themes - proactive and disciplined approach to physical activity and exercise, positive lifestyle factors - may facilitate broader multidimensional strengths-based approaches to pain. Experiences of recoverees are highlighted for consideration in future research.