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Title: Focusing outcome measurement for Transcutaneous Electrical Nerve Stimulation evaluation: incorporating the experiences of TENS users with chronic musculoskeletal pain.
Author: Gladwell, Peter William
Awarding Body: University of the West of England, Bristol
Current Institution: University of the West of England, Bristol
Date of Award: 2013
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This thesis has used qualitative interviews to generate knowledge about the use of Transcutaneous Electrical Nerve Stimulation (TENS) by patients with chronic musculoskeletal pain. This knowledge can inform the selection of appropriate outcome measures which are relevant to the patients' use of TENS, and can be used to focus the design of future TENS evaluations. Methods Semi-structured interviews were used to explore the perceived benefits of TENS reported by secondary ca re pain clinic patients with chronic musculoskeletal pain. The data were analysed using an ind uctive thematic analysis and a parallel, theo retical thematic analysis was undertaken to faci litate linking against other datasets and outcome measures. Two other forms of data generation were used to ens ure that a comprehensive understanding of the perceived benefits of TENS was developed. The analysis was compared with outcome measures used previously for TENS evaluations in chronic pain and chronic low back pain findings & impli ca tions The analysis indicated that TENS should be considered as a complex intervention, with benefits which extend beyond pain relief, including a red uction in muscle sensations (such as tension and spasm), and di straction from pain as separate benefits. Patients reported using TENS in a strategic manner, for example in order to manage pain fl are-ups, ach ieve functiona l goals, enhance rest periods and reduce medication. This indicates that outcomes need to be contextualised to the specific strategy of use. The benefits re ported by TENS users had a low degree of match against previously used outcome measures. This indicates that these previously used outcome measures have limi ted ca pacity to capture patient-reported benefits. An alte rna tive a pproach to outcome measurement is developed, which has the potential to test elements of the analysis developed in t hi s thesis, as well as enhancing the sensitivity of future TENS evaluations.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available