This study examines the concerns and beliefs about medication reported by patients with nonmalignant chronic pain encountered within general practice. Two hundred thirty-nine patients with chronic pain took part in this research. Patients completed the Pain Medication Attitudes Questionnaire, a measure of patient concerns and beliefs relating to addiction, withdrawal, side effects, mistrust in doctors, perceived need of medication, scrutiny from others, and tolerance. The data revealed that patient concerns and beliefs predicted general medication nonadherence. In addition, concerns were related to the direction of nonadherence: overuse of medication was related to increased perceived need for medication and greater concern over side effects; underuse was related to decreased concerns over withdrawal and increased mistrust in the prescribing doctor. Analyses also indicated that patient attitudes and concerns about medication were more predictive of nonadherence than both level of pain and the reported frequency of experienced side effects. This research contributes to the increasing evidence that patient attitudes and beliefs about pain medication are associated with adherence behavior. Training general practitioners to identify and address these concerns may reduce concerns, improve adherence, and facilitate the doctor-patient relationship.

Social workers play a vital role in maintaining and improving the lives of the service users that they work with. Despite this, the role is replete with high levels of stress-related sickness absence, turnover intentions and low levels of jobs satisfaction in addition to poor working conditions. This study sought to further investigate working conditions in the UK social workers, as well as the reasons for these working conditions via a mixed-methods survey and interview study. A total of 3,421 responses were gained from the cross-sectional survey which looked at working conditions, perceived stress, job satisfaction and turnover intentions (both migration and attrition), with the semi-structured interview schedule (n = 15) based on survey findings and analysed via thematic analysis continuing through to saturation. Similar to 2018, results demonstrated poor working conditions, irrespective of job role, and regression analysis suggested each of demands, control, managerial support, role and change influenced stress. Qualitative results found that workload, lack of managerial support and service user/family abuse were distinct demands associated with the role, whereas buffering positive resources were the social work role, peer support and positive managerial support. Implications for managerial practice, and harnessing the positive experience of peer support, are discussed.

In this methodological paper, we discuss the use of the nominal group technique to facilitate the involvement of people with chronic pain and other stakeholder groups in the design of a community-based pain management programme. On the basis of our experiences of using the technique in a study conducted in the south-west region of the UK, we explore conceptual and logistical issues relating to patient involvement in health service development, discuss political issues relating to the articulation and synthesis of different stakeholder perspectives, and provide a description of how the technique can be applied in the aforementioned context. We conclude that although the nominal group technique is not a panacea for the difficulties encountered in patient involvement, it does offer advantages over other approaches.

A training intervention for GPs including education on opioid guidelines for chronic pain and psychological flexibility training increased knowledge of prescribing and reduced concerns but did not change prescribing behavior or well-being. The training was highly acceptable to GPs but may have been too short to produce other effects.

The United Kingdom’s National Health Service (NHS) has a higher-than-average level of stress-related sickness absence of all job sectors in the country. It is important that this is addressed as work stress is damaging to employees and the organisation, and subsequently impacts patient care. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing in NHS employees from three employing NHS Trusts through a mixed-methods investigation. First, a cross-sectional organisational survey was completed by 1644 respondents. Questions examined working conditions, stress, psychological wellbeing, job satisfaction, and presenteeism. This was followed by 33 individual semistructured interviews with NHS staff from a variety of clinical and nonclinical roles. Quantitative findings revealed that working conditions were generally positive, although most staff groups had high levels of workload. Regression outcomes demonstrated that a number of working conditions influenced mental wellbeing and stress. Three themes were generated from thematic analysis of the interview data: wellbeing at work, relationships, and communication. These highlight areas which may be contributing to workplace stress. Suggestions are made for practical changes which could improve areas of difficulty. Such changes could improve staff wellbeing and job satisfaction and reduce sickness absence.