The association between patient–professional partnerships and self‐management of chronic back pain: A mixed methods study

Fu, Yu; Yu, Ge; McNichol, Elaine; Marczewski, Kathryn; Closs, S. José

doi:10.1002/ejp.1210

Cited by 12 publications

(13 citation statements)

References 52 publications

(57 reference statements)

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“…105,106 Patients identified several requirements when it comes to improving patient-centered pain management communication. 106 The most important was to have a shared decision-making process, 107 based on an assessment of patient needs and preferences and a commitment to address patient pain concerns through multiple avenues of pain management. In this regard, cannabis could be considered as a new therapeutic option for pain management in orthopaedic trauma.…”

Section: Dovepressmentioning

confidence: 99%

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Grzelak¹,

Bérubé²,

Gagnon³

et al. 2022

JPR

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To examine 1) pain management strategies within the care trajectory of orthopaedic trauma patients and patients' perception of their effectiveness, 2) adverse effects (AEs) associated with pharmacological treatments, particularly opioids and cannabis, and 3) patients' perceptions of strategies that should be applied after an orthopaedic trauma and support that they should obtain from health professionals for their use. Patients and Methods: This study was conducted with orthopaedic trauma patients in a level 1 trauma center. A convergent mixedmethods design was used. Data on pain experience, pain management strategies used and AEs were collected with self-administered questionnaires at hospital discharge (T1) and at 3 months after injury (T2). Patients' preferences about the pain management strategies used, the required support and AEs were further examined through semi-structured individual interviews at the same time measures. Descriptive statistics and thematic analyses were performed.Results: Seventy-one patients were recruited and 30 individual interviews were undertaken. Pharmacological pain management strategies used at T1 and T2 were mainly opioids (95.8%; 20.8%) and acetaminophen (91.5%; 37.5%). The most frequently applied non-pharmacological strategies were sleep (95.6%) and physical positioning (89.7%) at T1 and massage (46.3%) and relaxation (32.5%) at T2. Findings from quantitative and qualitative analyses highlighted that non-pharmacological strategies, such as comfort, massage, distraction, and physical therapy, were perceived as the most effective by participants. Most common AEs related to opioids were dry mouth (78.8%) and fatigue (66.1%) at T1 and insomnia (30.0%) and fatigue (20.0%) at T2. Dry mouth (28.6%) and drowsiness (14.3%) were the most reported AEs by patients using recreational cannabis. An important need for information at hospital discharge and for a personalized follow-up was identified by participants during interviews. Conclusion: Despite its AEs, we found that opioids are still the leading pain management strategy after an orthopaedic trauma and that more efforts are needed to implement non-pharmacological strategies. Cannabis was taken for recreational purposes but patients also used it for pain relief. Support from health professionals is needed to promote the adequate use of these strategies.

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Section: Dovepressmentioning

confidence: 99%

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Grzelak¹,

Bérubé²,

Gagnon³

et al. 2022

JPR

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“…However, social interventions for chronic pain are rare [ 12 , 21 ] and there is a need to understand how healthcare professionals can support these [ 22 , 23 ]. Pain research has focused on patient-professional relationships [ 24 , 25 ], with the significance of interpersonal peer-to-peer relationships outside the clinical environment being under-examined [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Experiences of Patient-Led Chronic Pain Peer Support Groups After Pain Management Programs: A Qualitative Study

et al. 2021

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Objective A qualitative study of patients’ experiences and the impacts of peer support groups that patients maintained after UK NHS group pain management programmes (PMPs). Design Long-term impacts of group PMPs remain unclear, with indications that positive effects can fade. We evaluated a model of continued peer support, co-produced by patients and clinicians, to maintain the therapeutic impact of PMP groups. A protocol was implemented that encouraged patients to continue to meet in their established PMP group for patient-led peer support (without clinical input) after PMPs finished. Peer support aimed to consolidate self-management, and advance social life recovery. We examined the impacts that groups had on attendees, and why some dropped out. Methods Semi-structured interviews with 38 patients and 7 clinicians, analysed thematically. Results Friendship bonds and mutual understandings of effective ways of coping with pain encouraged participants to maintain recovery following PMPs. After PMP professional involvement has ended, these meetings enabled patients to develop greater agency from the shared sense of helping bring about new achievements or averting setbacks. Peer support extended the understanding of what is possible when living with pain. However, continuing meetings were not right for all. Reasons for not attending included lack of connection with peers. Conclusions Co-produced peer support groups after PMPs can be a low-cost, effective social intervention, providing emotional, practical and social benefits, with improved self-management skills, stronger social connections and some reduced use of health services. Project resources for developing peer support meetings after PMPs are freely available online.

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“…19 Involving clinical staff members in the management of some chronic diseases such as diabetes and patients with hypertension has shown to be feasible. [19][20][21] Consequently, involving clinical staff members in providing education and information to patients with LBP might also be feasible and additionally improve the partnership with patients by focusing more on patient information and education. 20 However, barriers and facilitators for this change are currently unknown.…”

Section: Introductionmentioning

confidence: 99%

“… 19 – 21 Consequently, involving clinical staff members in providing education and information to patients with LBP might also be feasible and additionally improve the partnership with patients by focusing more on patient information and education. 20 However, barriers and facilitators for this change are currently unknown. 21 Knowledge of GPs’ barriers and facilitators can inform the design of a future intervention to address GPs’ capabilities, opportunities and motivation to include clinical staff members in treating LBP.…”

Section: Introductionmentioning

confidence: 99%

Involving practice nurse and other assistant clinical staff members in the management of low back pain: A qualitative interview study from Danish general practice

et al. 2021

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Objectives: Involving practice nurse and other assistant clinical staff members in providing information and education to patients with low back pain at follow-up appointments may release more time and improve care in general practice. However, this requires a shift in the division of tasks, and general practitioners’ barriers and facilitators for this are currently unknown. The objectives were to explore general practitioners’ experiences and perceptions of including assistant clinical staff members in the management of low back pain. Methods: This is a semi-structured interview study in Danish general practice. General practitioners with a variation in demographics and experience with task-delegation to clinical staff were recruited for in-depth interviews. We used a phenomenological approach to guide the data collection and the analysis in order to gain insight into the subjective experiences of the general practitioners and to understand the phenomenon of ‘delegating tasks to practice staff’ from the perspective of the general practitioners’ lifeworld. Analysis was conducted using an inductive descriptive method. The sample size was guided by information power. Results: We conducted five interviews with general practitioners. All general practitioners had experience with task delegation, but there was a variation in which tasks the general practitioners delegated and to which types of clinical staff members. The following themes were derived from the analysis: general practice organisation, delegating to clinical staff members, doctor–patient relationship, exercise instruction, clinical pathway for patients and external support. Conclusion: General practitioners consider patients with low back pain to be a heterogeneous group with a variety of treatment needs and a patient group without any predetermined content or frequency of consultations; this can be a barrier for delegating these patients to clinical staff members.

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The association between patient–professional partnerships and self‐management of chronic back pain: A mixed methods study

Cited by 12 publications

References 52 publications

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Experiences of Patient-Led Chronic Pain Peer Support Groups After Pain Management Programs: A Qualitative Study

Involving practice nurse and other assistant clinical staff members in the management of low back pain: A qualitative interview study from Danish general practice

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