Stefan Elbers

Overview of themes, subthemes and exemplary quotes of the data that was collected in the ‘discover’ phase. SOLACE SELF MANAGEMENT IN CHRONIC PAIN STRATEGIES Phase 2 ‘define’ 2.2 Posters Themes 1. Emptiness after treatment How will you cope with being on your own, after treatment? How do you keep believing in yourself and remain focused on important treatment insights? 2. Goals and values How do you maintain focus on your goals and values? How do you remain engaged? How do you stay on track rather than being distracted by the pain? 3. Coping with a setback What if things are not going well? Or if you forgot how to manage certain situations? What if you experience a setback? 4. Skills to prevent relapse What are important skills to prevent relapse? How can you train or promote these skills? How do they become a part of you? 5. Involving significant others How do you explain your treatment experiences to your significant others? How do you communicate that you have changed and what your new goals are? 6. Personal boundaries, pacing and monitoring energy How do you remain true to yourself and communicate your boundaries? How do you manage your energy levels and remain relaxed? 7. Improving after treatment How can you continue to improve after treatment? 8. Insight into own behaviours How do you acquire insight into your own behaviour and how things are going? How do you monitor your current level and your progress? How do you organize feedback and how should you ideally respond to this? Subthemes 1. Emptiness 2. Pride 3. Responsibility 4. Effective relationship with HCPs 5. Confidence 6. How to remain motivated to remain focused on treatment insights by yourself 7. Post-treatment contact between patient and HCP 1. Remembering goals and values 2. Differences between treatment centre and personal environment 3. Structured daily schedule 4. Planning daily activities 5. Motivation 6. Continuing pain interference 1. What if things are not going well 2. Live events and new injuries 3. Remembering treatment insights 4. Getting up after a setback 5. Asking for help 6. Talking with others 7. Integrating the topic of relapse in the treatment 1. Creativity 2. Impulsivity and courage 3. Positivity, joy and humor 4. Resilience, acceptance, letting-go 5. Reflecting 6. Self-compabssion 7. Distraction, shifting focus 1. Sharing experiences 2. Support and understanding 3. Barriers within the family 4. Habits 5. Attention 1. Rest 2. Making decisions and setting personal boundaries 3. High demands 4. Saying ‘no’ 5. Energy management 6. Limited by pain 1. End of treatment 2. Treatment successes? 3. Setting new goals 4. Back to the old personal environment 1. Self-insight 2. Monitoring behaviour 3. Receiving feedback Quotes “I am proud of my children and grandchildren. And I am also proud of what I achieved during the treatment program.” – patient, 1.2 “Confidence is an important topic during treatment. It helps if you show that you are confident that a patient is able to achieve his or her goals.” – HCP, 1.5 “Walking was my most important goal. Why? Because it gives me freedom.” - patient, 2.1 “You will not win the battle against the pain.. wouldn’t it be nice if to focus shifted from pain to general enjoyment of life?” – HCP, 2.6 “She [therapist] taught me to use the [graded activity] schedule for a couple of days, in case that I fall back into old habits.” - patient, 3.4 “I think it is a good thing if patients experience a setback during treatment. Than you can use this experience to make prevention plans in anticipation of future events.” - HCP, 3.7 Creativity is an important trait. If a strategy does not work, patients will have to find new solutions - HCP, 4.1 “I learned to have self-compassion. Before treatment, I used to punish myself, but now, I don’t do that anymore. If you like yourself, you are also prepared to take good care for yourself.” - patient, 4.6 “A patient can change, but if the social environment is not sufficiently supportive the chance of relapse will increase. That’s why it is important to involve the family during treatment.” - HCP 5.2 “My husband always wanted to care for me and to ensure that nothing bad happened. That was difficult for me, I had to ask him to stop interfering.” - patient, 5.3 “The treatment is successful if a patient regained control over his life. Not the pain is central, but his aims and desires in life.” - HCP, 6.4 “Planning my daily schedule in advance was useful for me. I learned how to distribute my time and energy by adhering to the schedule.” - Patient, 6.5 “We used to celebrate the end of a treatment period with a party and a couple of beers. But we don’t do that anymore. We do have a conversation about what we learned and how they experienced the program.” – group coach, 7.1 “After fifteen years of pain, I immediately wanted to check if I was ok, after treatment. I started kickboxing, which actually went quite well.” - patient, 7.3 “I learned to have more confidence in my body. That you actually can do whatever you want, but sometimes you need to do it slightly different than the rest.” – patient, 8.2 “Innovations and eHealth are opportunities to monitor patients after treatment and to signal relapse. That could be combined with online sessions with a psychologist.” - HCP, 8.2