Let’s talk about pain: A mixed methods exploration of patients’ pain knowledge and preferred ways to introduce the biopsychosocial model of pain

Background Clinical guidelines recommend treating chronic pain using a biopsychosocial (BPS) model, yet the biomedical model remains dominant. It is known that pain is complex and influenced by many factors but, to our knowledge, patient-centered ways to introduce the BPS model have not been explored.Aims Our primary aim was to explore patient-centered ways to introduce the BPS model of pain; second to this, we evaluated any changes in pain knowledge from baseline to follow-up.Methods We facilitated focus groups with people (n = 21) living with chronic pain. We employed blended reflexive and codebook thematic analysis to identify themes and subthemes and measured knowledge change (pre–post) using a paired t-test.Results We developed themes that pertained to knowledge of, and barriers and facilitators to, sharing the BPS model of pain. Participants reported a lack of knowledge sharing by providers, and the gap was supported by low accuracy on a pain physiology questionnaire. We interpreted barriers to knowledge sharing as bidirectional: with systemic barriers affecting knowledge delivery (i.e., time, biomedical bias) and person-level barriers affecting knowledge receptivity (i.e., fear of stigma, history of diagnoses). An approach involving meaningful validation, individualized tailoring, multiple modalities (i.e., posters, handouts, videos), and knowledge sharing by all providers earlier in the pain journey may serve as facilitators to support a BPS-focused dialogue.Conclusions Participants expressed a need for BPS model knowledge sharing. A patient-centered approach will prioritize validation, individualization, and the value of personal narratives for illustrating the brain’s role in the pain experience.