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Canadian Journal of Pain · May 2026

Let’s talk about pain: A mixed methods exploration of patients’ pain knowledge and preferred ways to introduce the biopsychosocial model of pain

Cynthia J. Thomson, Katherine N. Holden, Luisa V. Giles, Leanne Cianfrini

University of the Fraser Valley

Reflexive thematic analysisMixed methods Medicine

How they used Delve

Researchers at the University of the Fraser Valley used Delve to code four focus groups with 21 people living with chronic pain about how the biopsychosocial model of pain should be introduced to patients. Three researchers and a research assistant coded the transcripts independently in Delve, then met to reconcile codes and build themes with patient partners.

“Three researchers (C.J.T., L.V.G., L.C.) and a research assistant (K.N.H.) independently coded the transcripts using the cloud-based software Delve. The method we employed was reflexive inductive thematic analysis, informed by Braun and Clarke”

Field
Chronic pain / pain education
Data
Four focus groups (three online via Zoom, one in person) with 21 people living with chronic pain, transcribed verbatim; participants P1 to P21 with descriptors for pain condition, gender and age
Approach
Mixed methods: focus groups analysed with blended reflexive inductive and codebook thematic analysis (Braun and Clarke), with member reflections and patient partners refining themes; pre-post pain knowledge measured quantitatively
Data types
Focus groups

Abstract

Background: Clinical guidelines recommend treating chronic pain using a biopsychosocial (BPS) model, yet the biomedical model remains dominant. It is known that pain is complex and influenced by many factors but, to our knowledge, patient-centered ways to introduce the BPS model have not been explored. Aims: Our primary aim was to explore patient-centered ways to introduce the BPS model of pain; second to this, we evaluated any changes in pain knowledge from baseline to follow-up. Methods: test. Results: We developed themes that pertained to knowledge of, and barriers and facilitators to, sharing the BPS model of pain. Participants reported a lack of knowledge sharing by providers, and the gap was supported by low accuracy on a pain physiology questionnaire. We interpreted barriers to knowledge sharing as bidirectional: with systemic barriers affecting knowledge delivery (i.e., time, biomedical bias) and person-level barriers affecting knowledge receptivity (i.e., fear of stigma, history of diagnoses). An approach involving meaningful validation, individualized tailoring, multiple modalities (i.e., posters, handouts, videos), and knowledge sharing by all providers earlier in the pain journey may serve as facilitators to support a BPS-focused dialogue. Conclusions: Participants expressed a need for BPS model knowledge sharing. A patient-centered approach will prioritize validation, individualization, and the value of personal narratives for illustrating the brain’s role in the pain experience.

Citation

Cynthia J. Thomson, Katherine N. Holden, Luisa V. Giles, Leanne Cianfrini (2026). Let’s talk about pain: A mixed methods exploration of patients’ pain knowledge and preferred ways to introduce the biopsychosocial model of pain. Canadian Journal of Pain. https://doi.org/10.1080/24740527.2026.2650304

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