“Pacing does help you get your life back”: The acceptability of a newly developed activity pacing framework for chronic pain/fatigue

Antcliff, Deborah; Keenan, Anne‐Maree; Woby, Steve; Keeley, Philip; McGowan, Linda

Abstract

Objectives
We have developed and feasibility tested an activity pacing framework for clinicians to standardise their recommendations of activity pacing to patients with chronic pain/fatigue. This study aimed to explore the acceptability and fidelity to this framework in preparation for a future trial of activity pacing.
Design
Acceptability and fidelity were explored using semi‐structured interviews. Data were analysed using framework analysis.

Participants
Patients who attended a rehabilitation programme for chronic pain/fatigue underpinned by the framework, and clinicians (physiotherapists and psychological wellbeing practitioners) who led the programmes.

Results
Seventeen interviews were conducted, involving 12 patients with chronic pain/fatigue and five clinicians. The framework analysis revealed four deductive themes: (1) Acceptability of the activity pacing framework, (2) Acceptability of the feasibility study methods, (3) Processes of change and (4) Barriers and facilitators to activity pacing; and one inductive theme: (5) Perspectives of patients and clinicians.

Conclusions
The activity pacing framework appeared acceptable to patients and clinicians, and adherence to the framework was demonstrated. Processes of behaviour change included patients' regulation of activities through activity pacing. Barriers to pacing included work/social commitments and facilitators included identifying the benefits of pacing on symptoms. Different perspectives emerged between clinicians and patients regarding interpretations of symptom‐contingent and quota‐contingent strategies. The framework recognises fluctuations in symptoms of chronic pain/fatigue and encourages a quota‐contingent approach with flexibility. Future work will develop a patient friendly guide ahead of a clinical trial to explore the effects of pacing.

Citation

Antcliff, D., Keenan, A., Woby, S., Keeley, P., & McGowan, L. (2021). “Pacing does help you get your life back”: The acceptability of a newly developed activity pacing framework for chronic pain/fatigue. Musculoskeletal Care, 20(1), 99-110. https://doi.org/10.1002/msc.1557

• Journal Article Type: Article
• Acceptance Date: Mar 31, 2021
• Online Publication Date: May 6, 2021
• Publication Date: May 6, 2021
• Publicly Available Date: May 30, 2023
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Publisher: Wiley
• Volume: 20
• Issue: 1
• Pages: 99-110
• DOI: https://doi.org/10.1002/msc.1557
• Keywords: Nursing (miscellaneous), Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, Chiropractics, Rheumatology
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/msc.1557