Table 2.

Themes 1 and 2 and their sub themes

Theme 1 - Difficulties of operationalising PSE principles

Patients have passive and inappropriate beliefs about pain management, expecting medication and imaging

Patients could be aggressive in pursuing these interventions

Consultation times are limited making it ‘hard’ and a ‘fight’ to try to manage pain according to guidelines

Difficulties of changing patient beliefs.

Already stressful working environment with risk of litigation and comorbidities.

Explanation of a problem is not welcomed by patients.

Inadequate rapport with patients due to GP surgery structure and patients shopping around for the intervention they seek.

Theme 2 – Clinician affinity for PSE but difficulty communicating it.

Clinicians found the information very relevant and wanted to know more.

Clinicians felt that some of the information was new and that some of it was a refresher of what they knew.

The intervention gave them cause to reflect upon their management of pain.

They wanted more information that was suitable to share with patients to help patients to understand the information and therefore accept guideline-consistent pain management.

Limited appointment times make it harder to convey information or explain conditions like pain.

Benefits systems perpetuate the reporting of pain.

Clinicians sought ready ‘reels’ of information that they could convey to patients about the problem.

Clinicians also sought other pre-prepared sources of visual and/or audio sources to explain pain to their patients.

The PSE content was deemed to be very accessible to any audience.