University of Wisconsin–Madison Medical College of Wisconsin

Exploring Expressive Writing with Patients With Chronic Pain During Primary Care Visits

Cassandra C. Sundaram, MS; David G. Thoele, MD; Mary F. Henningfield, PhD; Jen Zaborek, MS; Shelbey Hagen, MSEc

WMJ. 2024;123(4):282-286.

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ABSTRACT

Background: Patients living with chronic pain may feel frustrated with and neglected by clinicians who care for them, leading to negative health care experiences. Clinicians may struggle to find new ways to engage and connect with patients experiencing chronic pain. Both patients and clinicians may benefit from expressive writing by potentially improving communication and creating a deeper sense of connection within medical visits.

Methods: An expressive writing activity, the Three-Minute Mental Makeover (3MMM), was conducted with 15 patients living with chronic pain during primary care visits with 5 UW Health family medicine physicians. Patient and physician experience using the 3MMM was measured using pre- and post-visit surveys and individual interviews.

Results: Both physicians and patients viewed the experience of doing the 3MMM together positively. We identified 8 key themes from individual follow-up interviews with patients and physicians: (1) opening the door, (2) insight into the doctor/patient as a person, (3) peer-to-peer communication, (4) closeness and connection, (5) comfort and relaxation, (6) unexpected learning, (7) unexpected value to patients, and (8) vulnerability and self-disclosure. The most commonly reported barriers to physicians using the activity in practice were lack of time and persuading other physicians to do the activity.

Discussion: Patients with chronic pain and the clinicians who care for them may benefit from an expressive writing exercise, such as the 3MMM, in the key realms of building relationships, communication, and trust.


Author Affiliations: Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health (UWSMPH) (Sundaram, Henningfield, Hagen); Biostatistics and Medical Informatics, UWSMPH (Zaborek); Advocate Children’s Hospital, Park Ridge, Illinois (Thoele).
Corresponding Author: Cassandra C. Sundaram, MS, Research Specialist, 909 Dartmouth Ave SE, Minneapolis, MN 55414, phone 608.769.3439; email sunda063@umn.edu.
Financial Disclosures: None declared.
Funding/Support: This research was funded by the Department of Family Medicine and Community Health at the University of Wisconsin School of Medicine and Public Health.
Acknowledgments:
The authors thank the patient and clinician participants involved in this project for their time, patience, and willingness to explore this topic. They also wish thank Deb Constien, BS, RD, and Cindy Burzinski, MS, for valuable contributions to proposal development and submission.
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