PAINSTORIES – Exploring the challenges, barriers and self-management needs of adolescents with ongoing onset knee pain trough semi-structured patient interviews.

Patient education is essential to enable rehabilitation and self-management of longstanding knee pain in adolescents. Currently, a lack of insights into the socio-cognitive processes governing adolescents’ self-management remains an obstacle for enhancing treatment and education efficacy. The Painstories study aimed to develop a conceptual model for integrating adolescents’ challenges and barriers into future treatments, based on qualitative interviews with young adults who had experienced knee pain emerging during adolescence.

In depth semi-structured interviews was conducted with 14 young adults (age 21-25 years) with knee pain since adolescence (9 years mean duration). Temporal developments in participants’ knee pain were captured trough a memorization exercise. Data was analyzed via the General Inductive Approach. The emerging themes were organized into a matrix, based on the identified temporal developments. This informed a conceptual model, which was tested with eight additional young adults with knee pain during adolescents.

The analysis identified how participants aquisition of self-managment followed a four-stage trajectory of; gaining awareness, knowledgeability, contextual application and reconceptualization, each with different challenges and dilemmas, participants had to overcome to progress their self-management. Testing the conceptual model, confirmed stages and highlighted acceptance as key to overcoming barriers.

In summary, the study described adolescents’ integration of self-management as proximal and inquiry-based, with acceptance, driving increasingly complex management behaviors. We hypothesize future interventions may benefit from exploring supporting adolescents’ inquiries into their knee pain at different stages of the trajectory.