Experiences of a Web-Based Nursing Intervention—Interviews with Women with Chronic Musculoskeletal Pain

Jelin, Elma; Granum, Vigdis; Eide, Hilde

doi:10.1016/j.pmn.2011.08.008

Cited by 29 publications

(37 citation statements)

References 42 publications

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“…Our findings build on earlier research suggesting digital communication allows highly emotional and intimate communication and may help patients talk about difficult aspects of their conditions and thus develop a constructive relationship with the RN . These findings are important, as patients claim that HCP do not have time to listen to them in regular consultations .…”

Section: Discussionsupporting

confidence: 80%

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

Lie

Karlsen

Graue

et al. 2019

Scandinavian Caring Sciences

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Background A constructive patient–nurse relationship is beneficial in self‐management support approaches. Research indicates eHealth interventions hold a potential for self‐management support for adults with type 2 diabetes. However, eHealth may change the patient–nurse relationship. No studies to date have addressed how eHealth self‐management support interventions with written asynchronous communication can influence the relationship between patients and nurses. Aim The aim of this study was to explore how an eHealth intervention based on the Guided Self‐Determination program (eGSD) influences the patient‐nurse relationship from the perspective of patients participating and the nurses conducting the intervention. Methods A qualitative approach with individual semi‐structured interviews was used. Ten patients with type 2 diabetes who completed the eGSD and four nurses who delivered the intervention participated. The data were transcribed verbatim, and qualitative content analysis was used to analyse the text. Results The findings revealed two themes: ‘eGSD facilitates a reciprocal understanding and a flexibility in the relationship’ and ‘eGSD creates a more fragile relationship’, reflecting ambiguous experiences with the eGSD. Conclusion and relevance to clinical practice The findings indicate that eGSD influences the patient–nurse relationship by facilitating reciprocal understanding and flexibility. Both patients and RNs acknowledged these outcomes as beneficial. Nevertheless, familiar in‐person consultations were expressed as integral for the patient–nurse relationship. As written communication in eHealth is a novelty, it demands new knowledge and expertise that RNs must master. Findings from this study may therefore be acknowledged when developing and implementing eHealth interventions. Education programs in written eHealth communication, as well as guidelines and frameworks on how to professionally and effectively conduct eHealth services while maintaining supportive patient–nurse relationships, should be a priority for institutions that educate healthcare personnel, health institutions and other stakeholders.

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Section: Discussionsupporting

confidence: 80%

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

Lie

Karlsen

Graue

et al. 2019

Scandinavian Caring Sciences

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“…Despite the high withdrawal rate, most experienced the present intervention as useful. In a qualitative study with 7 of our participants, the intervention was described as motivating and supportive [63]. …”

Section: Discussionmentioning

confidence: 99%

A Smartphone-Based Intervention With Diaries and Therapist-Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain: Randomized Controlled Trial

Kristjánsdóttir¹,

Fors²,

Eide³

et al. 2013

J Med Internet Res

Self Cite

143

261

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BackgroundInternet-based interventions using cognitive behavioral approaches can be effective in promoting self-management of chronic pain conditions. Web-based programs delivered via smartphones are increasingly used to support the self-management of various health disorders, but research on smartphone interventions for persons with chronic pain is limited.ObjectiveThe aim of this trial was to study the efficacy of a 4-week smartphone-delivered intervention with written diaries and therapist feedback following an inpatient chronic pain rehabilitation program.MethodsA total of 140 women with chronic widespread pain who participated in a 4-week inpatient rehabilitation program were randomized into 2 groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of 1 face-to-face session and 4 weeks of written communication via a smartphone. Participants received 3 smartphone diary entries daily to support their awareness of and reflection on pain-related thoughts, feelings, and activities. The registered diaries were immediately available to a therapist who submitted personalized written feedback daily based on cognitive behavioral principles. Both groups were given access to a noninteractive website after discharge to promote constructive self-management. Outcomes were measured with self-reported questionnaires. The primary outcome measure of catastrophizing was determined using the pain catastrophizing scale (score range 0-52). Secondary outcomes included acceptance of pain, emotional distress, functioning, and symptom levels.ResultsOf the 140 participants, 112 completed the study: 48 in the intervention group and 64 in the control group. Immediately after the intervention period, the intervention group reported less catastrophizing (mean 9.20, SD 5.85) than the control group (mean 15.71, SD 9.11, P<.001), yielding a large effect size (Cohen’s d=0.87) for study completers. At 5-month follow-up, the between-group effect sizes remained moderate for catastrophizing (Cohen’s d=0.74, P=.003), acceptance of pain (Cohen’s d=0.54, P=.02), and functioning and symptom levels (Cohen’s d=0.75, P=.001).ConclusionsThe results suggest that a smartphone-delivered intervention with diaries and personalized feedback can reduce catastrophizing and prevent increases in functional impairment and symptom levels in women with chronic widespread pain following inpatient rehabilitation.Trial RegistrationClinicaltrials.gov NCT01236209; http://www.clinicaltrials.gov/ct2/show/NCT01236209 (Archived by WebCite at http://www.webcitation.org/6DUejLpPY)

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“…Nurses could also provide web-based counselling and follow-up selfmanagement support for patients with chronic pain, using text-based communications and instant messaging. In a 4-week pilot study of such a system, patients reported it to be both motivating and supportive 49 . Most pharmacists believe they would benefit from additional education and training, particularly in two specific areas: advising patients on self-medication for (mainly acute) pain, and the use of opioid analgesics for managing chronic pain (in accordance with physicians' instructions) -consideration should be given to making appropriate pain management education in this area mandatory 50 .…”

Section: Undergraduate and Postgraduate Education And Trainingmentioning

confidence: 99%

A holistic approach to chronic pain management that involves all stakeholders: change is needed

Kress

Aldington

Alon

et al. 2015

Current Medical Research and Opinion

126

103

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Chronic pain affects a large proportion of the population, imposing significant individual distress and a considerable burden on society, yet treatment is not always instituted and/or adequate. Comprehensive multidisciplinary management based on the biopsychosocial model of pain has been shown to be clinically effective and cost-efficient, but is not widely available. A literature review of stakeholder groups revealed many reasons for this, including: i) many patients believe healthcare professionals lack relevant knowledge, and consultations are rushed, ii) general practitioners consider that pain management has a low priority and is under-resourced, iii) pain specialists cite non-adherence to evidence-based treatment, sub-optimal prescribing, and chronic pain not being regarded as a disease in its own right, iv) nurses', pharmacists' and physiotherapists' skills are not fully utilized, and v) psychological therapy is employed infrequently and often too late. Many of the issues relating to physicians could be addressed by improving medical training, both at undergraduate and postgraduate levels - for example, by making pain medicine a compulsory core subject of the undergraduate medical curriculum. This would improve physician/patient communication, increase the use of standardized pain assessment tools, and allow more patients to participate in treatment decisions. Patient care would also benefit from improved training for other multidisciplinary team members; for example, nurses could provide counseling and follow-up support, psychologists offer coping skills training, and physiotherapists have a greater role in rehabilitation. Equally important measures include the widespread adoption of a patient-centered approach, chronic pain being recognized as a disease in its own right, and the development of universal guidelines for managing chronic non-cancer pain. Perhaps the greatest barrier to improvement is lack of political will at both national and international level. Some powerful initiatives and collaborations are currently lobbying policy-making bodies to raise standards and reduce unnecessary pain - it is vital they continue.

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Experiences of a Web-Based Nursing Intervention—Interviews with Women with Chronic Musculoskeletal Pain

Cited by 29 publications

References 42 publications

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

A Smartphone-Based Intervention With Diaries and Therapist-Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain: Randomized Controlled Trial

A holistic approach to chronic pain management that involves all stakeholders: change is needed

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