Exploring healthcare providers’ perceptions regarding the prevention and treatment of chronic pain in breast cancer survivors: A qualitative analysis among different disciplines

Abstract

Background The prevention and treatment of chronic pain problems in breast cancer follow-up care require an adequate response from healthcare providers. Generally, this involves the uptake of evidence-based principles regarding pain management in everyday practice. However, despite the extensive literature on effective pain interventions, systematic and coordinated follow-up care is lacking for breast cancer survivors with pain problems in Flanders, Belgium. Objective This study aimed to gather insight into healthcare providers’ perceptions of pain prevention and treatment in breast cancer follow-up care, particularly with attention to the multilevel influences on pain follow-up. Methods We conducted four online focus groups with twenty-two healthcare providers from different disciplines such as oncologists, pharmacists, nurses, physiotherapists, and psychologists. Data analysis was guided by the Qualitative Analysis Guide of Leuven. This guide is inspired by the constant comparison method, based on Grounded Theory. Results The identified influencing factors were thematically grouped into four levels: at the level of the individual healthcare provider, in interaction with the patient, in interaction with colleagues, and at the context level. At each level, we distinguished factors related to healthcare providers’ perceptions such as awareness, knowledge, attitudes, beliefs, experiences, and intentions. For example, because of a lack of knowledge and certain beliefs among healthcare providers, referral to other disciplines often does not happen in the context of pain. Conclusion This study points out the need to explore the prevention and treatment of chronic pain after breast cancer from a multidimensional point of view. This involves not only the characteristics of individual healthcare providers but is also inherently interactional and system-like in nature. This analysis provides opportunities for the development of interventions that target the influencing factors of prevention and treatment of chronic pain in breast cancer survivors.

Development of an intervention aimed at the prevention and treatment of chronic pain in breast cancer survivors: An intervention mapping approach

“…Some of the major themes were described in Table 1. The results from our focus groups will also be reported in more detail elsewhere [81].…”

‘I think it affects every aspect of my life, really’: Cancer survivors’ experience of living with chronic pain after curative cancer treatment in England, UK

“…At times, participants felt that health care professionals did not believe their chronic pain after cancer treatment really existed. Healthcare professionals can underestimate the prevalence, severity and impact of pain in cancer survivors [52]. Further research into health care professionals' knowledge and understanding of chronic pain after cancer treatment is in progress by the authors of this paper.…”

Survivors’ perceptions regarding the follow-up of pain complaints after breast cancer treatment: Distinct coping patterns

“…Despite the acknowledged impact of pain in the literature, pain is often not timely assessed nor adequately monitored in practice ( Neefs and Lauwers, 2016 ; Runowicz et al, 2016 ; Slaghmuylder et al, 2022 ). Cancer survivors report a lack of physical and psychological support after the initial treatment phase ( Neefs, 2017 ).…”