105: Self-Management Practice, Barriers, and Facilitators in People Living with Chronic Pain in Ethiopia

Topic: Basic Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, , , , , , Behavioral studies, , ,

Background and Aims: Self-management (SM) is a key component of chronic pain care, requiring individuals to play active roles in managing their pain[1]. Cultural beliefs and perceptions towards pain strongly shape health-seeking behaviour[2]. Effective SM interventions depend on patients’ ability to modify unhealthy behaviours and adopt healthier ones. Therefore, assessing patients’ experiences, knowledge, skills, and confidence in managing their conditions is essential. Understanding barriers and enablers within behavioural change frameworks is also crucial for designing effective SM programs. This study aimed to explore the patient experiences, barriers, and facilitators of SM among Ethiopian individuals with chronic pain using the Theoretical Domains Framework (TDF)[3].

Methods: This study employed an explanatory qualitative design with face-to-face semi-structured interviews at two purposively selected tertiary public hospitals in Ethiopia. Adults aged 18 and older with clinician- or self-diagnosed chronic pain were purposively recruited. Information power determined the final sample size. Interview questions and analysis were guided by TDF, with probes adopted from prior literature[3, 4]. Interviews were conducted from February to April 2025, audio-recorded, and accompanied by field notes. Interviews were transcribed verbatim in Amharic and translated into English. Data were managed and coded in NVivo 15. An inductive-deductive thematic analysis followed Braun and Clark’s six-step approach[5].

Results: A total of 30 interviewees were interviewed, each lasting from 18 to 55 minutes. The mean (SD) age of the participants was 46 (15) years. A thematic analysis emerged with five main themes and 14 subthemes. Main themes include: (1) People with chronic pain use multi-modal strategies to manage their pain, viewing SM as a continuous personal responsibility and survival strategy. (2) Knowledge, beliefs, and emotions shape SM engagement; (3) Social and environmental contexts strongly influence SM practice; (4) Motivations, goals, and intentions sustain long-term SM practice; and (5) Decision-making in SM practice is dynamic and context dependent.

Conclusions: This study highlights that chronic pain SM is a complex, dynamic process shaped by personal, social, and environmental factors. People living with chronic pain integrate multiple SM strategies: active, passive, traditional, and religious activities, to live with and manage their pain. Support from family, social, and healthcare professionals, alongside the barriers, strongly influences and shapes SM practice. Overall, SM is highly individualised and context dependent, underscoring the need for tailored and flexible support.

References: 1. Mann, E.G., S. LeFort, and E.G. VanDenKerkhof, Self-management interventions for chronic pain. Pain management, 2013. 3(3): p. 211-222.
2. Baum, E., et al., “I could not bear it”: Perceptions of chronic pain among Somali pastoralists in Ethiopia. A qualitative study. Plos one, 2023. 18(11): p. e0293137.
3. Cane, J., D. O’Connor, and S. Michie, Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation science, 2012. 7: p. 1-17.
4. Eilayyan, O., et al., Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention. Chiropr Man Therap. 2019; 27: 44. Behav Sci (Basel), 2021. 11(11).
5. Braun, V. and V. Clarke, Thematic analysis: A practical guide. 2021.

Presenting Author: Moges Gashaw
Submitting Author: Moges Gahaw

Senior Author: Bruno T Saragiotto

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Luke C Jenkins: PhD - Brain Stimulation and Rehabilitation Lab, School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
• Rafael Zambelli Pinto: PhD - Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia; and Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
• Mark Overton: PhD - Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia
• Saurab Sharma: PhD - Pain Management and Research Centre, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, Australia; Pain Management Research Institute, Kolling Institute and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, and Northern Sydney Local Health District, Sydney, Australia; School of Health Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia, and Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
• Arianne Verhagen: PhD - Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia
• Bruno T Saragiotto: PhD - Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia; and Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil