Treatment journey of spinal cord stimulation surgery: an interpretative phenomenological analysis

Turner, Anna (2012) Treatment journey of spinal cord stimulation surgery: an interpretative phenomenological analysis. DClinPsy thesis, University of Nottingham.

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Introduction: This thesis explored Chronic Neuropathic Pain (CNP) patients' experiences of the treatment journey of Spinal Cord Stimulation (SCS) surgery, considering life prior to, and after the surgery. Previous SCS literature has predominantly focused on technology, SCS efficacy, and the role of psychological factors in SCS patient selection and outcomes. Whilst research highlights SCS as an effective treatment for various CNP conditions, it predominantly employs quantitative outcome measures, thereby reducing the depth of information yielded about the experience of SCS surgery and patient satisfaction. There is a dearth of in-depth understanding of the lived experience of the SCS surgery treatment journey.

Objectives: The aim of this thesis was to explore participant experiences of the SCS surgery treatment journey considering life prior to and after the surgery.

Methods: Ethical and NHS trust approval were obtained. A purposive sample of seven CNP patients who had undergone SCS surgery 2-8 months previously were recruited. Each participant took part in a face-to-face semi-structured interview which was audio recorded. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA).

Results: Three super-ordinate themes were generated: Diminished control and coping, identity transitions and SCS conflict. The themes were interpreted as being interconnected with each other. To demonstrate the treatment journey, all themes were included in the journal paper and further details of convergences and divergences between participants were included in the extended paper.

Discussion: In line with previous research, patients’ expectations of SCS surgery were significant in patient satisfaction with the outcomes, reinforcing the importance of identifying and addressing expectations in pre-surgery preparation. Given SCS is often the last treatment option; the current study found post-SCS participants were going through a process of acceptance of lost identities and of current pain relief and capabilities. Simultaneously, participants were adjusting to living with the stimulator, indicating the significance of offering psychological treatments adjunct to SCS treatment to support participants through these processes. Difficulties in acceptance of identity changes and adjustment to SCS could negatively impact on mood and sense of control which can have adverse effects on pain perception.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: das Nair, R.
Macniven, J.
Basu, S.
Keywords: Spinal cord stimulation, Chronic neuropathic pain, Patient perspective, Qualitative research, Interpretative phenomenological analysis, Lived experience
Subjects: W Medicine and related subjects (NLM Classification) > WL Nervous system
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > Institute of Work, Health and Organisations
UK Campuses > Faculty of Medicine and Health Sciences > School of Community Health Sciences
Item ID: 12807
Depositing User: EP, Services
Date Deposited: 12 Aug 2016 12:02
Last Modified: 15 Dec 2017 21:32

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