Chronic Pain Online: Delineating Stakeholders’ Posts with the Bifurcated Method

Pain is the most typical health complaint for which people seek medical care, and chronic pain (lasting more than 3 months) is a source of disability worldwide. Currently, individuals participate in business, personal, and social interactions online—including blogs, forums, and social media. The research problem is a dearth of investigations of pain stakeholders’ posts online. The aim of our study was to assess online posts of persons with chronic pain and other pain stakeholders, like caregivers, health and mental health providers, government/other agencies, and researchers. Employing the Bifurcated Method (inductive, thematic analysis followed by webcrawls with a computer application which quantitizes themes), four researchers evaluated online narratives at websites regarding chronic pain. Online postings were our frames of analysis; stakeholder categories were domains for differential assessment. Inductive analysis involved an open coding strategy with repeated, independent readings of text from approximately 60 posts at 10 different randomly selected websites from a larger pool of 83. It was followed by consensus-building meetings. Afterward, our webcrawler counted frequencies of key words. Two meta-themes spanning all domains were: “providing information” (100% saturation) and “offering or seeking some sort of assistance” (i.e., information or support; 60% saturation). Content within posts related to key themes of: (1) “describing symptoms or characteristics of chronic pain” (100% saturation); (2) “feeling desperation” (60% saturation); (3) “mental health impacts or comorbidities with pain” (40% saturation); and (4) “awareness, gratitude, self-understanding, and mindfulness linked to chronic pain” (40% saturation). It is vital to consider what chronic pain stakeholders are doing on the Internet in relation to pain and how this might influence the health, mental health, and well-being of those involved. These collaborations are called “Health Co-Inquiry”, but questions loom as to whether Health Co-Inquiry online can lead to improved outcomes. Implications for clinical practice include balancing information against misinformation, providing varied support (such as peer support online), and elevating client/patient advocacy—all of which are linked to clients’ psychological well-being.