Activating waitlists - Identifying barriers and facilitators to pain self-management while waiting

Sep 29, 2026

Uploaded by Jiven

Waitlists for pain management services are often extensive, contributing to psychological and physical decline and reducing patient engagement after access. For outpatient pain management, no standardized waiting list interventions exist, leaving people to wait passively. Using inductive qualitative methods with semi-structured interviews and COM-B/Theoretical Domains Framework, the study identifies key barriers and one facilitator to inform waitlist intervention development.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Objectives

Design

Method

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Introduction

Original Manuscript Activating waitlists: Identifying barriers and facilitators to pain self-management while waiting British Journal of Pain 2025, Vol. 0(0) 1–13 © The Author(s) 2025 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/20494637241311456](DOI: 10.1177/20494637241311456) [journals.sagepub.com/home/bjp](journals.sagepub.com/home/bjp) Lydia V Tidmarsh 1 􀀁, Richard Harrison2 􀀁, Harriet Wilkinson3 , Megan Harrington3 and Katherine A Finlay 1 􀀁 Abstract Objectives: Waitlists for pain management services are often extensive, risking psychological and physical decline and patient non-engagement in treatment once accessed. Currently, for outpatient pain management, no standardised waiting list interventions exist, resulting in passive waiting. To arrest prospective wait-related decline(s), this study aimed to identify the barriers and facilitators to pain selfmanagement while waiting, forming the foundation for a waitlist intervention development. Design: An inductive qualitative approach was utilised to explore the barriers and drivers of pain selfmanagement while waiting for chronic pain management. Method: Semi-structured interviews, underpinned by the Theoretical Domains Framework and COM-B model, were conducted with people waiting for pain management services (N = 38) . Interviews were audiorecorded, transcribed verbatim, and analysed via reﬂexive thematic analysis. Results: The analysis demonstrated four thematised barriers and one facilitator: (1) Shunted Around the System (barrier); (2) The Information Gap (barrier); (3) Resisting Adaptation (barrier); (4) Losing Hope (barrier); and (5) Help Yourself or Lose Yourself (facilitator) . Conclusion: This study demonstrates the severe emotional and motivational impact of waiting, increasing treatment disengagement. The waitlist represents a prime opportunity for prehabilitation to protect wellbeing and optimise self-management engagement. Infrastructural and interpersonal barriers of poor communication and healthcare professional pain invalidation must be addressed to improve emotional wellbeing and motivation to engage with planned treatment. Enhancing self-efﬁcacy, pain acceptance, self-compassion, and internal HLOC are fundamental to increasing pain self-management. These can all be met within a prehabilitation framework. This study is foundational for the development of psychological prehabilitation in outpatient chronic pain management. Keywords Behaviour change, health-locus of control, pain management, prehabilitation, qualitative, reﬂexive thematic analysis 1School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK 2Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, UK 3 Royal Berkshire Hospital, Reading, UK Corresponding author: Katherine A Finlay, Health Psychology, School of Clinical and Language Sciences, University of Reading, Harry Pitt Building, Whiteknights Campus, RG6 6AH, Reading, Berks, UK. Email: Katherine.ﬁ[nlay@reading.ac.uk](nlay@reading.ac.uk) Introduction Globally, healthcare services are under signiﬁcant economic and resource strains, resulting in extensive waitlists.1 In chronic pain management, recommended waiting times are a maximum of two-months for nonurgent, and one-month for urgent cases.2 However, currently, global pain management timelines more typically range between eight months and two years3,4; risking severe detriment for people living with chronic pain (PLwCP) waiting for treatment. Signiﬁcantly elevated levels of stress, pain, functional impairment, anxiety and depression are associated with long treatment delays.5–9 These detrimental effects are rapid; psychological decline can occur within ﬁve weeks of waiting, 10 therefore average pain management waittimes drastically exceed this critical time-window. Treatment attrition consequ

FAQs

Why are waiting lists for pain management a problem?

Long waitlists can lead to psychological and physical decline and reduce treatment engagement once care is accessed.

What did the study aim to do?

To identify barriers and facilitators to pain self-management while waiting, providing a foundation for developing a waitlist intervention.

What barriers and facilitator were identified?

The study found four barriers: being shunted around the system, an information gap, resisting adaptation, and losing hope, plus one facilitator: helping yourself or lose yourself.

Sep 29, 2026

Uploaded by Jiven