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.

Patient education plays an important role in rehabilitation and teaching self-management to adolescents struggling with longstanding knee pain. Currently we have little knowledge on the pain related, social and cognitive processes which drives adolescents’ procurement of self-management skills. This lack of knowledge inhibits the development of new and improved patient education concepts.

This study explored the challenges, barriers and self-management needs experienced by adolescents with knee pain though in-depth qualitative interviews and memorization exercises with 14 young adults with knee pain since adolescents. The analysis identified 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.

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.

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.