Objectives: To use a psychosocial framework to examine the pain experiences of low-income, ethnically diverse patients before and after an Integrative Pain Management Program (IPMP).Design and methods: IPMP is a 12-week, multimodal pain group incorporating mindfulness, acupuncture, massage, education, movement, and health coaching. The authors conducted semistructured interviews at the beginning, end, and 3 months following completion of IPMP. Interviews were digitally recorded and transcribed and analyzed using inductive coding methods.Setting: A primary care clinic in San Francisco, CA, serving low-income, ethnically diverse patients, many of whom are marginally housed and living with disabilities.Subjects: Forty-one patients with a diagnosis of chronic pain, currently receiving prescription opioids and referred by their primary care provider, who participated in IPMP.Results: Authors thematically analyzed 104 individual interviews with 41 IPMP participants, including 41 baseline, 35 three-month follow-up, and 28 six-month follow-up. Before IPMP, participants described a psychologic ''vicious cycle'' of pain symptoms that worsened with movement and anxiety, while increasing their sense of disempowerment and social isolation. Following IPMP, patients reported using new strategies to manage pain, including lowering medication use, resulting in an emerging sense of psychologic resilience, and more social connections.Conclusions: IPMP offers an accessible model for addressing psychosocial aspects of chronic pain. Vulnerable patients engaged with integrative medicine groups and developed new perspectives and tools for managing their pain; they emerged feeling hopeful and resilient. These results support the use of integrative medicine groups for targeting psychosocial aspects of chronic pain within primary care.

Acupuncture is feasible, safe, and acceptable in an ICU setting by patients from diverse backgrounds.

Operating on the core premise of microhistory, that the lives of ordinary people are endowed with explanatory power for a specific period or event in history, this article analyses the war-time letters from the 1950s written by an American serviceman and his girlfriend, later wife, during the Korean War. The author addresses methodological concerns regarding implications that the unique characteristics of personal letters have on the utilization of them as primary source material in historical and biographical writing, in addition to reflections on the author’s close familial relationship to the historical subjects and how this impacts the overall objectivity of the article. An analysis of the letters demonstrates how the couple developed various techniques to mitigate the effects of distance and how they coped with the pervasive sense of uncertainty and fear that consumed Cold War America. This study broadly contributes to the existing life writing literature by demonstrating how a life writing approach, when applied to a particular moment in history, can be utilized in historical study to tell a previously untold part of that particular moment.