Dominant frames and counter-frames in chronic pain: A scoping review protocol

Aim To identify and describe the dominant frames and counter-frames used to represent chronic pain. Introduction Chronic pain is a significant cause of worldwide disability. Within the UK, 43% of adults are estimated to be living with some form of chronic pain. This figure is increasing, driven in part by an ageing population. Responses to conventional treatments for chronic pain, such as pharmacological and surgical interventions are often variable. The introduction of a biopsychosocial approach to counter this has been criticised for biomedical drift in clinical practice. In parallel, chronic pain is regularly framed within health literature as a biomechanical issue, resolvable by medical intervention. Such frames may obscure the need to consider structural, environmental or social and community led solutions. In turn, this may create and perpetuate existing inequities in care for marginalised groups. Chronic pain frames have received little attention in health research. Using the domains of Entman’s framing concept, this scoping review seeks to address this gap by identifying and describing the dominant frames and counter-frames used to represent chronic pain. Inclusion criteria Studies that report on, or discuss the social representation, frames or narratives in relation to chronic pain conditions as recognised by the ICD-11, section MG30 and its sub-sections. Quantitative and qualitative studies will be considered, as will non-empirical perspective or opinion papers. Grey literature which discusses chronic pain as major focus will be included. Grey literature will cover publicly available content on preselected websites, including sites representing conditions beyond those included in the ICD-11, MG30, where chronic pain is a significant factor. Exclusion criteria Studies which focus on outcomes related to treatment or interventions for chronic pain or those which do not focus on social representation. Books, theses and dissertations. Studies and grey literature not published in English. Any grey literature or academic literature published before 7th April 2021 (the release date of the latest NICE chronic pain guidelines) will also be excluded. Methods Published, peer-reviewed literature will be searched within CINAHL, MEDLINE, PubMed and PsycINFO databases. Preselected grey literature websites will include charities, non-profit organisations, NHS, private healthcare, professional bodies and OSF pre-prints/registrations. This will be supplemented by Google and Google Scholar hand-searches. Data will be extracted into an Excel spreadsheet. Academic literature will be assessed using Entman’s four domains of framing to extract details of frames or representations identified by the selected papers. Grey literature sources will also be analysed according to the four domains of Entman’s framing concept. Subsequent rounds of qualitative coding will result in the production of chronic pain frames and their descriptions which will be presented in a tabular format.