Figure 1
Veterans’ relationship with Chronic Pain—Theory of veterans’ response/coping strategies for long-term pain (LTP)—Core theory of army veteran coping.
Appendix 1
Bartlett & Payne’s (1997) procedure for Grounded Theory (Lyons & Coyle, 2007).
| Collecting data | Interviews were conducted in person (at a gym and closed beauty salon) or over the telephone, as per participant’s preference. Interviews were semi-structured and based on open-ended questions. Questions were loosely based on the COPE scale (Carver, Scheier, & Weintraub, 1989), because that is the most popular coping questionnaire used in health research (Kato, 2015). The questions were expanded to get a fuller account of coping, and were action-oriented to seek an account of ‘how’ coping occurs. See Electronic Supplementary Material 1 for a copy of the interview schedule. Whilst interviewing was an iterative process for each participant, some participants were asked additional probing questions if an interesting point prompted further exploration. If an interesting point arose in a previous interview, this may direct additional questions in subsequent interviews with subsequent participants. No two interviews were identical. Interviews lasted between 20 and 112 minutes. No non-verbal cues were noted from face to face to interviews, on the basis that this information would be missing from the telephone interviews. |
| Transcribing data | Interviews were transcribed verbatim, and anonymised transcripts were stored in NVivo for analysis. Each interview was transcribed and analyzed as soon as the interview was conducted. |
| Develop initial categories using open coding | Starting with the first transcript, initial codes and categories were assigned to interesting pieces of text. Participant’s own words were used as labels were possible. |
| Saturate the categories | In subsequent transcripts other instances of the codes/categories were sought out. Saturation occurs when no new categories or codes appear in the transcripts. Saturation of categories/codes was reached at four participants. |
| Define the categories | Categories/codes are narrowed to broader overarching themes. See supplementary file 2 for an example of this process. |
| Theoretical sampling | More participants are interviewed to ascertain if the defined themes appear in their transcripts. Two more participants were interviewed. |
| Axial coding | Relationships between the themes are observed. These relationships are tested by returning to the data; in this case the six transcripts. |
| Theoretical integration | A core category or theory is proposed to explain the relationship between the themes. |
| Grounding the theory | The proposed theory is tested by returning to the data; the six transcripts. A search for deviant cases against the data is conducted. |
| Testing the theory | Another new participant is interviewed, to test the theory (and themes) with new data. The seventh participant. |
Appendix 2
Table1 Participant characteristics.
| N | |
|---|---|
| Gender | |
| Male | 6 |
| Female | 1 |
| Age | |
| 31–40 | 2 |
| 41–50 | 4 |
| 51–60 | 1 |
| (mean age 46 years) | |
| Number of English regions veterans currently reside | 6 |
| Length of service | |
| 11–15 years | 3 |
| 15–20 years | 2 |
| 20< | 2 |
| (mean length of service 18 years) | |
| Corporal/Sergeant | 3 |
| Staff Sergeant | 4 |
| Reasons for leaving the Army | |
| Pregnancy | 1 |
| Completed service (22 year service) | 2 |
| Medical discharge | 2 |
| Career change | 2 |
| Number of different regiments the veterans served with | 6 |
| Currently serving in the Reserves | 2 |
| Employment | |
| Employed | 6 |
| Unemployed | 1 |
| Marital status | |
| Single | 1 |
| Married | 2 |
| Divorced | 1 |
| Living with partner | 1 |
| Did not say | 2 |
Appendix 3
Table 2 Pain characteristics.
| N | |
|---|---|
| Bodily regions where pain occurred | |
| Neck | 2 |
| Shoulders | 1 |
| Arms/elbows/wrists/hands | 3 |
| Back | 4 |
| Torso/stomach | 1 |
| Hips | 2 |
| Legs/knees/ankles/feet | 2 |
| Pain in multiple bodily pain sites | 5 |
| Length of time suffered pain | |
| 0–5 years | 2 |
| 6–10 years | 3 |
| 11–20 years | 1 |
| 15–20 years | 1 |