How do peer support interventions for the self-management of chronic pain, support basic psychological needs? A systematic review and framework synthesis using self-determination theory

Objective: To identify how peer support interventions, for self-management of chronic pain, support basic psy-chological needs from a self-determination theory (SDT) perspective, using a systematic review. Methods: Ten databases were searched for studies reporting qualitative research about peer interactions in pain management interventions. 'Best fit' framework synthesis methodology was applied to identify strategies that support the satisfaction of competence, autonomy and motivation. These were matched to definitions of stra-tegies provided by standardised taxonomies. Results: 18 studies were selected for inclusion. The synthesis resulted in a conceptual model, identifying 12 peer strategies that support psychological needs for self-management of chronic pain; 10 overlapped with existing taxonomies. Conclusion: This was the first known attempt to synthesise evidence about peer support strategies for people living with pain, using SDT as an a priori framework. The model demonstrates commonality between the motivation-promoting processes of peer support and those of other behaviour change interventions and identifies additional unique strategies provided by peers. This systematic classification of peer support strategies provides a means for future study of the efficacy and comprehensiveness of peer interventions. Practice implications: The model could assist healthcare professionals and support groups to optimise the potential of peer processes.