Health literacy and pain neuroscience education in an interdisciplinary pain management programme: a qualitative study of patient perspectives

INTRODUCTION: Pain neuroscience education is part of interdisciplinary pain management programs (IPMPs). To date, the role of health literacy on patients' understanding of pain neuroscience education has not sufficiently been examined. OBJECTIVES: Drawing on interviews with patients with diverse levels of health literacy, this article explores patient perspectives on pain neuroscience education. METHODS: Purposively sampled patients from an IPMP were interviewed twice (waiting list and after 4 weeks). A directed qualitative content analysis was performed with the Integrated Conceptual Model of Health Literacy as an analytic framework. RESULTS: Thirteen patients with chronic musculoskeletal pain were interviewed: 4 men and 9 women aged from 21 to 77 years with diverse educational and mostly low health literacy. One participant dropped out after baseline. Some participants gained access to health information actively; others relied on the expertise of their healthcare providers. Most participants did not seem to receive the information in the pain neuroscience education as intended, experienced difficulties with understanding the message, negatively appraised the information, and were not able to apply this in their daily lives. Health literacy levels likely played a role in this. CONCLUSIONS: Pain neuroscience education tailored to patients' health literacy levels, information needs, and learning strategies is needed.