Living well with chronic pain: a classical grounded theory

Purpose: There is little theory to explain how and why some people cope well despite chronic pain. This study proposes a mid-level theoretical explanation for those that cope well, shedding light on factors relevant to acceptance. Method: Classical grounded theory methodology was closely followed to generate a theory grounded in data obtained from community-dwelling people self-identified as living well despite chronic pain. Results: The main concern of people experiencing chronic pain is resolving the problem of disrupted self-coherence. Resolution involves re-occupying self by (1) making sense of pain using an idiographic model; (2) deciding to turn from patient to person, facilitated or hindered by interactions with clinicians and occupational drive; and (3) flexibly persisting, where occupational engaging and coping allow individuals to develop future plans. Conclusions: This theory demonstrates the importance of engaging in occupation during rehabilitation by framing chronic pain adjustment within a process of renegotiating the self-concept. Occupations allow individuals to express values important to their sense of self. Coping strategies are used to enable occupation and are judged by their workability in this context. When developing goals and plans with people living with pain, rehabilitation professionals should consider an individual's position within the processes involved in learning to live well.