Experiences of Veteran and Civilian Patients in Exploratory Yoga Sessions for Chronic Pain: A Qualitative Study.

Background: Yoga integrates all aspects of self, with biological, mental, intellectual, and spiritual elements. The practice of yoga aligns with the biopsychosocial model of health and, as such, it can be instrumental in pain treatment. Aims: The purpose of this qualitative study was to explore perceptions regarding the yoga sessions for chronic pain through thematic content analysis with comparison of gender, veteran or civilian status, and delivery methods. Methods: Patients with chronic pain attended a 5-week intensive interdisciplinary chronic pain management program at the Michael G. DeGroote Pain Clinic. Participants were asked to complete six open-ended questions following four weekly 1-h yoga classes, through in-person or virtual delivery. Survey responses were thematically and separately analyzed by reviewers. Results: Forty-one (N = 41) participants (56% males, 71% veterans) with an average age of 50.87 (SD 10.10) years provided comments. Nine themes emerged: (1) mind and body are one through yoga practices; (2) meaningful practice of yoga basics is productive for range of motion/movement, tension in joints, and chronic pain; (3) yoga classes provide an enjoyable process of learning; (4) yoga reminds patients of their physical capabilities; (5) routine practices lead to improvements; (6) yoga improved on strategies for chronic pain; (7) yoga can be adapted for each patient; (8) mindset improves to include positive thinking, better focus, and willingness to try new things; and (9) improvements exist for the current yoga programming. Conclusion: Findings of the current study were nine qualitative themes that present the experience of patients with chronic pain in the yoga sessions.

Contexte: Le yoga intègre tous les aspects de la personne et comporte des éléments biologiques, mentaux, intellectuels et spirituels. La pratique du yoga s'aligne sur le modèle biopsychosocial de santé et, à ce titre, elle peut jouer un rôle déterminant dans le traitement de la douleur.Objectifs: Le but de cette étude qualitative était d'explorer les perceptions concernant les séances de yoga pour la douleur chronique grâce à une analyse thématique du contenu avec comparaison entre les sexes, entre le statut de civil ou celui d'ancien combattant, et entre les modes de prestation.Méthodes: Les patients souffrant de douleur chronique ont suivi un programme interdisciplinaire intensif de prise en charge de la douleur chronique d'une durée de cinq semaines à la Clinique de la douleur Michael G. DeGroote. Les participants ont été invités à répondre à six questions ouvertes à la suite de quatre cours de yoga hebdomadaires d'une heure, en personne ou virtuellement. Les réponses à l'enquête ont été analysées de manière thématique et séparée par les évaluateurs.Résultats: Quarante et un (N = 41) participants (56 % d'hommes, 71 % d'anciens combattants), dont l'âge moyen était de 50,87 ans (ET 10.10) ans, ont fourni des commentaires. Neuf thèmes ont émergé : (1) l'esprit et le corps ne font qu'un grâce à la pratique du yoga; (2) la pratique significative des bases du yoga est productive pour l'amplitude des mouvements, la tension dans les articulations et la douleur chronique; (3) les cours de yoga offrent un processus d'apprentissage agréable ; (4) le yoga rappelle aux patients leurs capacités physiques ; (5) la pratique routinière conduit à des améliorations; (6) le yoga a amélioré les stratégies face à la douleur chronique; (7) le yoga peut être adapté à chaque patient; (8) l'état d'esprit s'améliore et inclut la pensée positive, une meilleure concentration et la volonté d'essayer de nouvelles choses; et (9) le programme de yoga actuel peut être amélioré.Conclusion: Le résultat de la présente étude était la recension de neuf thèmes qualitatifs présentant l'expérience des patients souffrant de douleur chronique lors des séances de yoga.

A Qualitative Study of the Latter Effects of the COVID-19 Pandemic on Patients Living With Chronic Pain.

This qualitative study examined the effects of the COVID-19 pandemic on the lives of patients living with chronic pain (CP). Patients referred to an interdisciplinary pain management program between July and December of 2021 were asked to respond to the question: "How did the COVID-19 pandemic affect your life?" Fifty-four patients provided comments in response to this question. The comments were analyzed using an inductive approach. Ten themes emerged: (1) psychological state, (2) limitations on social life and activities, (3) minimal to no effect, (4) beliefs and opinions associated with COVID-19, (5) family dynamics, (6) healthcare disruptions, (7) pandemic-related fear, (8) changes in work, (9) change in pain, and (10) getting COVID-19. These themes mirror those found during the onset of the pandemic, with the addition of theme #4. Themes demonstrate the challenges experienced by individuals living with CP, in addition to new developments in the latter portion of the COVID-19 pandemic. It is important to understand the ramifications of shutdowns, so we are better able to address issues that occur in their aftermath.

Views on and experiences with medicinal cannabis among Canadian veterans who live with pain: A qualitative study.

Background: During fiscal year 2021-2022, Veterans Affairs Canada (VAC) reimbursed 18,388 veterans for medicinal cannabis at a cost of $153 million. Yet, it is not known whether the reimbursement program is producing a net benefit for veterans. Aims: This study investigated the views and experiences Canadian that veterans who live with pain have about medicinal cannabis use, including its use for the management of chronic pain, poor sleep, and emotional distress. Methods: Twelve Canadian veterans who live with pain-eight men, four women; split across four focus groups-were recruited to participate in a semistructured discussion around their experiences with medicinal cannabis use. Results: Using inductive thematic analysis, seven broad categories were identified: (1) cannabis use behaviors, (2) reasons for cannabis use, (3) outcomes from cannabis use, (4) facilitators of cannabis use, (5) barriers to cannabis use, (6) stigma around cannabis use, and (7) questions and concerns about cannabis use. Conclusions: Most veterans initiated cannabis use to manage the symptoms of preexisting medical and/or mental health conditions. Despite some negative side effects, most veterans reported improvements in their overall quality of life, sleep, relationships, mood, and pain. Concern remains around the discrepancy between veterans' qualitative reports of beneficial outcomes from medicinal cannabis use and equivocal findings around the benefit-to-harm ratio in the wider literature. Currently, the VAC reimbursement program remains challenged by unclear indication for which veterans, with what condition(s), at what dose, and in what form medical cannabis is most beneficial.

Contexte: Au cours de l'exercice 2021­2022, Anciens Combattants Canada (ACC) a remboursé 18 388 anciens combattants pour le cannabis médicinal, pour un coût de 153 millions de dollars. Pourtant, on ne sait pas si le programme de remboursement donne lieu à un bénéfice net pour les anciens combattants.Objectifs: Cette étude porte sur les points de vue et les expériences des anciens combattants canadiens qui vivent avec la douleur sur la consommation de cannabis médicinal, y compris son utilisation pour la gestion de la douleur chronique, les problèmes de sommeil et la détresse émotionnelle.Méthodes: Douze anciens combattants canadiens qui vivent avec la douleur - huit hommes et quatre femmes répartis en quatre groupes de discussion - ont été recrutés pour participer à une discussion semi-structurée autour de leurs expériences avec la consommation de cannabis médicinal.Résultats: Une analyse thématique inductive a permis d'établir sept grandes catégories : (1) les comportements de consommation de cannabis, (2) les raisons de la consommation de cannabis, (3) résultats de la consommation de cannabis, (4) les facteurs qui facilitent la consommation de cannabis, (5) les obstacles à la consommation de cannabis, (6) la stigmatisation autour de la consommation de cannabis et (7) les questions et préoccupations concernant la consommation de cannabis.Conclusions: La plupart des anciens combattants ont commencé à consommer du cannabis pour gérer les symptômes de maladies préexistantes et/ou des problèmes de santé mentale. Malgré certains effets secondaires négatifs, la plupart des anciens combattants ont signalé une amélioration de leur qualité de vie globale, de leur sommeil, de leurs relations, de leur humeur et de leur douleur. La préoccupation demeure autour de l'écart entre les rapports qualitatifs des anciens combattants décrivant les résultats bénéfiques de la consommation de cannabis médicinal et les résultats équivoques autour du rapport bénéfice/effet néfaste dans la littérature plus large. Actuellement, le programme de remboursement d'ACC reste contesté en raison d'indications peu claires concernant pour quels vétérans, atteints de quelles affections, à quelle dose et sous quelle forme le cannabis médical est le plus bénéfique.

Transition to Virtual Care Services during COVID-19 at Canadian Pain Clinics: Survey and Future Recommendations.

Introduction: Due to the COVID-19 pandemic, healthcare centers quickly adapted services into virtual formats. Pain clinics in Canada play a vital role in helping people living with pain, and these clinics remained essential services for patients throughout the pandemic. This study aimed to (1) describe and compare the transition from in-person to virtual pain care services at Canadian pain clinics during the onset of the COVID-19 pandemic and (2) provide postpandemic recommendations for pain care services to optimize the quality of patient care. Materials and Methods: We used a qualitative participatory action study design that included a cross-sectional survey for data collection and descriptive analysis to summarize the findings. Survey responses were collected between January and March of 2021. The survey was administered to the leadership teams of 11 adult pain clinics affiliated with the Chronic Pain Centre of Excellence for Canadian Veterans. Responses were analyzed qualitatively to describe the transition to the virtual pain services at pain clinics. Results: We achieved a 100% response rate from participating clinics. The results focus on describing the transition to the virtual care, current treatment and services, the quality of care, program sustainability, barriers to maintaining virtual services, and future considerations. Conclusions: Participating clinics were capable of transitioning pain care services to the virtual formats and have in-person care when needed with proper safety precautions. The pandemic demonstrated that it is feasible and sustainable for pain clinics to have a hybrid of virtual and in-person care to treat those living with pain. It is recommended that moving forward, there should be a hybrid of both virtual and in-person care for pain clinics. Ministries of Health should continue to develop policies and funding mechanisms that support innovations aimed at holistic healthcare, interdisciplinary teams, and the expansion of clinics' geographical reach for patient access.

A Qualitative Study of the Impact of the COVID-19 Pandemic on a Sample of Patients With Chronic Pain.

This qualitative phenomenological study examined the impact of the COVID-19 pandemic on the lives of patients living with chronic pain. Patients referred to an intensive interdisciplinary pain management program between June 2020 to June 2021 were asked, "How did the COVID-19 pandemic affect your life?" as part of their interdisciplinary assessment. Ninety patients (50 Veterans, 40 civilians) provided comments to this question, which were independently organized into themes using an inductive approach by 4 researchers. Nine main themes emerged: (1) changed psychological state, (2) minimal to no effect, (3) affected personal life activities, (4) changes in accessing care, (5) changes in work/education situation, (6) changes in family dynamics, (7) experiencing more annoyances, (8) COVID-19 pandemic is a barrier to making positive changes, and (9) got COVID-19. Themes are consistent with topics of interest in light of this ongoing, global stressor. Most commonly reported themes reflected changes in psychological well-being and changes in access to care, highlighting similarities between life with chronic pain and life under the pandemic for this group.