The aim of this study was to gain to understand and build deeper knowledge about how people with chronic widespread pain (CWP) experience the of a health plan for sustainable physical activity, working in partnership with a physiotherapist, supported by a digital platform.
Qualitative semi structured in-depth individual interviews were analyses with qualitative content analysis. Setting Five primary healthcare centers in western Sweden.
Participants
The interviewees comprised 19 individuals with CWP who had previously participated in a personcentred intervention involving co-creation of a health plan and support via a digital platform. The interviews were carried out from late 2019 to spring 2020, 1–6 months after the respondents' final follow-up.
Results
The analysis resulted in an overarching theme; hope for physical activity that actually works, illustrating the experience of taking part in co-creating a reasonable health plan, based on the respondents' own goals and interests with the potential to actually work. This theme was based on two categories: a plan tailored for me and a frame for participation and accessibility to help fulfil the plan. The digital platform provided a way to participate and an assurance that there was someone there for them if necessary. Conclusions
The co-creation of a health plan nurtured hope of having developed a manageable plan for physical activity that could lead to improved future health and wellbeing. Digital support may serve as a valuable complement in order to sustain and adjust the planned physical activity.
Approximately 10%–15% of the population worldwide suffer from chronic widespread pain (CWP),1 2 and it is more common in women than in men. and reduced quality of life.4–7 Physical activity is recommended as first choice treatment in CWP, and individually adjusted regular physical activity has been shown to improve pain, physical capacity, and ability to manage activities of daily life. However, physical activity is challenging for people with CWP due to impaired endogenous pain inhibition, which often causes increased pain during or following physical loading.11 It is therefore essential to develop strategies for long-term sustainability of physical activity for people with CWP.
The respondents in this study were individuals with CWP who had previously participated in a multicentre randomized controlled trial (RCT) evaluating the effects of 22 Inclusion criteria were, fulfilling the criteria of CWP according to the American College of Rheumatology,3 and participating in the intervention group allocated to digital support. Respondents were recruited from the three study sites, 1–6 months after their final follow-up. Eligible respondents were informed about the study by telephone and invited to participate. If they agreed to participate, they received additional written and oral information about the study and an interview was scheduled. According to our experiences from previous studies, 15–20 interviews were estimated to be sufficient to answer the research question.
Patient and public involvement
The intervention was created by physiotherapists and scientists together with a patient research partner with chronic pain from the Swedish Rheumatoid Association. The patient research partner was involved in the planning of the RCT as well as planning of the interview study but no patient or public partner was involved in the conduct or analysis of the interview study Of the 27 women and men who were asked to participate 20 agreed to this and scheduled a meeting.
One respondent was unable to attend the scheduled meeting due to illness, and so 19 respondents (16 women and 3 men) participated in the interviews: 10 in person in a healthcare setting and 9 by telephone (due to the COVID-19 pandemic). The interviews were carried out from late 2019 to spring 2020. Demographic characteristics of the respondents are presented in table 1. Seventy-five per cent of the respondents were employed. Self-estimated pain was 66 mm on a 0–100 mm Visual Analogue Scale26 and the Fibromyalgia Impact Questionnaire showed moderate impact on health.27 The analysis resulted in one theme: hope for physical activity that actually works. This was comprised of two categories: a plan tailored for me and a frame for participation and accessibility to help fulfil the plan. Each category had several subcategories elaborating on the striving towards sustainable health-enhancing physical activity when living with CWP.
