scholarly journals Current practices of health care providers in recommending online resources for chronic pain self-management

2019 ◽  
Vol Volume 12 ◽  
pp. 2457-2472
Author(s):  
Hemakumar Devan ◽  
Hazel Godfrey ◽  
Meredith Perry ◽  
Dagmar Hempel ◽  
Barbara Saipe ◽  
...  
2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.


2014 ◽  
Vol 19 (5) ◽  
pp. 257-265 ◽  
Author(s):  
Jennifer N Stinson ◽  
Chitra Lalloo ◽  
Lauren Harris ◽  
Lisa Isaac ◽  
Fiona Campbell ◽  
...  

BACKGROUND: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain.OBJECTIVES: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™.METHODS: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario. Interdisciplinary health care providers were also recruited from these sites. Three focus groups were conducted with adolescents (n=16) and one with pediatric health care providers (n=7). Individual adolescent interviews were also conducted (n=7).RESULTS: Qualitative analysis uncovered four major themes: pain impact; barriers to care; pain management strategies; and transition to adult care. Pain impacted social, emotional, physical and role functioning, as well as future goals. Barriers to care were revealed at the health care system, patient and societal levels. Pain management strategies included support systems, and pharmacological, physical and psychological approaches. Transition subthemes were: disconnect between pediatric and adult systems; skills development; parental role; and fear/anxiety. Based on these identified needs, the iCanCope with Pain™ architecture will include the core theory-based functionalities of: symptom self-monitoring; personalized goal setting; pain coping skills training; peer-based social support; and chronic pain education.CONCLUSIONS: The proposed iCanCope with Pain™ program aims to address the self-management needs of adolescents with chronic pain by improving access to disease information, strategies to manage symptoms and social support.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cecilie Varsi ◽  
Ingrid Konstanse Ledel Solem ◽  
Hilde Eide ◽  
Elin Børøsund ◽  
Olöf B. Kristjansdottir ◽  
...  

Abstract Background Chronic pain constitutes a significant burden for the individuals affected, and is a frequent reason why patients seek health care services. While in-person psychosocial interventions can be of support to people living with chronic pain, such interventions are not always accessible. eHealth interventions may provide greater accessibility, but the evidence and use of digital self-management solutions for chronic pain are still limited and the lack of health care provider input in the development process of such solutions a concern. Therefore, the aim of the current study was to investigate health care providers’ experiences of treating patients with chronic pain, their attitudes towards, and use of, digital solutions in pain management, and their suggestions for content and design elements for a potential digital pain self-management intervention. Methods Twelve health care providers representing a variety of health care disciplines participated in semi-structured interviews. The interviews were analyzed using thematic analysis. Results The material was analyzed into three main themes: [1] Patients with chronic pain and their current use of the health care services, [2] Health care providers’ own motivation and impression of patient prerequisites for use of digital self-management interventions, and [3] Suggestions for content and design elements in a digital self-management intervention for people living with chronic pain. The challenges faced by patients living with chronic pain were described as numerous. Despite interest and positive attitudes, few of the health care providers had used or recommended eHealth solutions to their patients. A range of potential content and functionality elements were identified, including aspects of motivation and engagement and providers also emphasized the importance of easy access and positive, personal content to support existing treatment. Conclusions This study offers insights into health care providers’ considerations for the potential of digital self-management interventions supporting patients living with chronic pain. Findings indicate the need for change and a more comprehensive treatment approach to pain management. eHealth solutions may contribute to such change, and providers pointed to a need for health care provider involvement, timely support and follow-up as important factors for integrating digital pain self-management interventions into clinical care. Trial registration ClinicalTrials.gov: NCT03705104


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mridula Bandyopadhyay

Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.


CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 11-13
Author(s):  
Shakila Mohmand ◽  
Sumar Chams

Cultural competency within health care helps eliminate racial and ethnic health disparities. When assessing and treating patients with chronic pain, practitioners should feel confident in using information regarding a patient’s individual cultural beliefs due to their significant impact on the pain experience. Culture impacts perception, outlook, and communication of pain, as well as coping mechanisms. These are aspects of subjective history that influence important decisions regarding the management of chronic pain. Becoming more aware of what to look for and which questions to ask can allow naturopathic doctors and other health-care providers to continue improving therapeutic relationships and patient outcomes.


2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.


Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1331-1346 ◽  
Author(s):  
Steven P Cohen ◽  
Zafeer B Baber ◽  
Asokumar Buvanendran ◽  
Brian C McLean ◽  
Yian Chen ◽  
...  

Abstract Background It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric comorbidities, and has been causally linked to the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with the responsibility to limit spread of the contagion and to treat the patients they are entrusted to care for. Methods To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document within a one-week period. Results In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and intervention-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization. Conclusions The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, and the welfare of health care providers.


2000 ◽  
Vol 50 ◽  
pp. 419 ◽  
Author(s):  
Kingsley U Onyemere ◽  
Rebecca B Lipton ◽  
Hilary K Kupelian ◽  
Kamal El Deirawi ◽  
Michael G Walsh ◽  
...  

2021 ◽  
Author(s):  
Sean M. O'Dell ◽  
Heidi R Fisher ◽  
Victoria Schlieder ◽  
Tracey Klinger ◽  
Rachel L Kininger ◽  
...  

BACKGROUND Despite innovations to integrate behavioral health practitioners in primary care settings and online adaptations of effective parenting programs, access to care gaps persist for youth and families in need. Behavioral intervention technologies (BITs) represent a modality for targeted prevention with promise for transforming primary care behavioral health by empowering parents to take charge of their child’s behavioral health care. In order to realize the potential of BITs, research is needed to understand parental needs in a BIT, as well as the status quo of parent self-help and parent-provider collaboration to identify and address behavioral health challenges. OBJECTIVE Engage parents and health care providers to better understand unmet needs and current practices to inform continued development of a BIT for parents to address common behavioral health challenges. METHODS We conducted a convergence validation mixed methods study in which parent quantitative surveys (N=385) on preferences and current practices related to behavioral health themes to be addressed in a BIT were integrated with focus group interview data on internal and external contextual factors contributing to parental unmet needs and current practices with 48 health care stakeholders in 9 child-serving clinics within a large, predominantly rural health system. We integrated these data using joint displays and synthesized areas of confirmation, expansion, and discordance between parents and health care stakeholders. RESULTS Parents frequently endorsed about half of the available themes in their “top 3”, indicating that BITs may not be the preferred modality for all targeted prevention. Additionally, parents also frequently endorsed themes that were not related to child psychopathology (e.g., parenting stress and family communication), indicating parents are interested in guidance on parenting beyond challenging child behavior. Health care stakeholders indicated that an online platform aligns with how parents already seek behavioral health guidance and suggested that a BIT may connect families with evidence-based guidance sooner. We identified areas of convergence related to overt behavior problems (e.g., disruptive behavior, nutrition and eating), and areas of divergence related to internalizing problems and cross-cutting issues that may be more difficult for health care providers to detect. Data integration helped to expand our understanding with regard to factors that may lead to more effective parent-provider partnerships, including the impact of limited time pressure office visits and a deeper understanding of how unmitigated parenting stress interrelates with qualities of parent help-seeking behavior. CONCLUSIONS These findings provide a rich understanding of the complexity involved in meeting parents’ needs for behavioral health guidance in a primary care setting using BITs. Further triangulation of these findings in user testing studies for BIT prototypes is needed to refine our understanding of how to successfully develop and implement an effective BIT to guide parents in taking charge of their child’s behavioral health care. CLINICALTRIAL N/A


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