scholarly journals Health Care Systems Support to Enhance Patient-Centered Care: Lessons from a Primary Care-Based Chronic Pain Management Initiative

2017 ◽  
Author(s):  
Charles Elder
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Health Care Systems ◽  
Patient Centered Care ◽  
Chronic Pain Management ◽  
Patient Centered ◽  
Centered Care ◽  
Care Systems

scholarly journals The Impact of Pain Invisibility on Patient-Centered Care and Empathetic Attitude in Chronic Pain Management

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Emilie Paul-Savoie ◽  
Patricia Bourgault ◽  
Stéphane Potvin ◽  
Emilie Gosselin ◽  
Sylvie Lafrenaye
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Clinical Experience ◽  
Patient Centered Care ◽  
Chronic Pain Management ◽  
Patient Centered ◽  
Chronic Pain Patients ◽  
Centered Care ◽  
The Impact ◽  
Pain Patients

Objectives. The use of interdisciplinary patient-centered care (PCC) and empathetic behaviour seems to be a promising avenue to address chronic pain management, but their use in this context seems to be suboptimal. Several patient factors can influence the use of PCC and empathy, but little is known about the impact of pain visibility on these behaviours. The objective of this study was to investigate the influence of visible physical signs on caregiver’s patient-centered and empathetic behaviours in chronic pain context. Methods. A convenience sample of 21 nurses and 21 physicians participated in a descriptive study. PCC and empathy were evaluated from self-assessment and observer’s assessment using a video of real patients with chronic pain. Results. The results show that caregivers have demonstrated an intraindividual variability: PCC and empathetic behaviours of the participants were significantly higher for patients who have visible signs of pain (rheumatoid arthritis and complex regional pain syndrome) than for those who have no visible signs (Ehler–Danlos syndrome and fibromyalgia) (p<0.001). Participants who show a greater difference in their patient-centered behaviour according to pain visibility have less clinical experience. Discussion. The pain visibility in chronic pain patients is an important factor contributing to an increased use of PCC and empathy by nurses and physicians, and clinical experience can influence their behaviours. Thus, pain invisibility can be a barrier to quality of care, and these findings reinforce the relevance to educating caregivers to these unconscious biases on their behaviour toward chronic pain patients.

scholarly journals Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

2020 ◽  
Vol 17 (8) ◽  
pp. 2842
Author(s):  
Vinita Agarwal
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Patient Centered Care ◽  
Self Management ◽  
Seasonal Cycles ◽  
Chronic Pain Management ◽  
Patient Assessment ◽  
Patient Centered ◽  
Centered Care ◽  
The Individual

Background: Ayurveda’s preventive focus complements its strength with the interventionist approach of the biomedical in chronic pain self-management. Patient-centered care (PCC) using ethnomedicine promises greater patient self-management; however, few studies have examined environmental relationships and PCC in self-management of chronic pain through Ayurveda. Objective: To examine how Ayurveda’s philosophical focus on whole system frameworks describes the integration of the individual and the ecological in tailoring an integrative patient-centered diagnostic and prognostic approach to chronic pain management. Methods: This qualitative case study conducted in-depth semi-structured interviews of Ayurvedic physicians from India (N = 10) and a qualitative inductive content analytic approach. Findings: The diagnostic and interpretational framework of the doshas supports the integration of the individual and the ecological through (a) the circadian and seasonal cycles relating mind-body awareness with diet, lifestyle (e.g., yoga), and breath (e.g., pranayama), and (b) biogeographical and ecosystemic regions relating the biogeographical and the ecological (e.g., desh) with the regulatory principle of pain and its physiological and anatomical perception (vata) in an approach that goes beyond treating pain etiology to a whole person PCC approach. Conclusions: The study highlights how circadian and seasonal cycles and evolutionary spatial-temporal factors of biogeographical and ecological regions are employed in patient assessment and self-management to support patient involvement. Recommendations for PCC in integrative chronic pain management include supporting patient ownership of their care through the dosha framework that relates the individual and the ecological in the patient’s own life-context and supports co-creation of a collaborative plan of care using an ethnomedical framework.

scholarly journals Hearing New Voices: Registered Nurses and Health Technicians Experience Caring for Chronic Pain Patients in Primary Care Clinics

2014 ◽  
Vol 8 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Linda H. Pellico ◽  
Wesley P. Gilliam ◽  
Allison W. Lee ◽  
Robert D. Kerns
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Registered Nurses ◽  
Primary Care Clinic ◽  
Patient Centered Care ◽  
Valuable Insight ◽  
Patient Centered ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Centered Care

Recent national estimates from the U.S. reveal that as many as one-third of all Americans experience chronic pain resulting in high prevalence rates of visits to primary care clinics (PCC). Indeed, chronic pain appears to be an emerging global health problem. Research has largely ignored the perspective of PCC staff other than physicians in providing care for patients with chronic pain. We wanted to gain insights from the experiences of Registered Nurses (RNs) and Health Technicians (HTs) who care for this patient population. Krippendorff’s method for content analysis was used to analyze comments written in an open-ended survey from fifty-seven primary care clinic staff (RNs-N=27 and HTs-N=30) respondents. This represented an overall response rate of 75%. Five themes emerged related to the experience of RNs and HTs caring for patients with chronic pain: 1) Primacy of Medications and Accompanying Clinical Quandaries; 2) System Barriers; 3) Dealing with Failure; 4) Primacy of Patient Centered Care; and 5) Importance of Team Based Care. This study demonstrates that nursing staff provide patient-centered care, recognize the importance of their role within an interdisciplinary team and can offer valuable insight about the care of patients with chronic pain. This study provides insight into strategies that can mitigate barriers to chronic pain management while sustaining those aspects that RNs and HTs view as essential for improving patient care for this vulnerable population in PCCs.

scholarly journals The Patient-Centered Approach: A Review of the Literature and Its Application for Acoustic Neuromas

2019 ◽  
Vol 81 (03) ◽  
pp. 280-286
Author(s):  
Christopher S. Hong ◽  
Jennifer Moliterno
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Skull Base ◽  
Holistic Approach ◽  
Patient Centered Care ◽  
Review Of The Literature ◽  
Patient Centered ◽  
Medical Specialties ◽  
Acoustic Neuromas ◽  
Centered Care

AbstractPatient-centered care is defined as “care that is consistent with and respects the values, needs, and wishes of patients” and is best achieved when clinicians involve patients and their support system in health care discussions and decisions. While this approach has been well established and supported in more general medical specialties, such as primary care, that may encompass a more holistic approach, it has rarely been described in surgical disciplines. Acoustic neuromas (ANs) can be unique among other skull base and intracranial pathologies, in that the management of these tumors can vary from patient to patient depending on various factors. Moreover, typical options, including observation, radiation, and surgery, may often have equipoise for some patients and their tumors. Therefore, a patient-centered approach, strongly guided by the expertise of experienced skull base surgeons, may likely be the most appropriate type of care for patients with ANs. Herein, we review the documented use of patient-centered care in other aspects of medicine, propose the benefits of this approach for patients with ANs, and provide ways this can be better implemented in practice.

scholarly journals Concordance and Patient-Centered Care in Medicaid Enrollees’ Care Experience With Providers

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Iwimbong Kum Ghabowen ◽  
Neeraj Bhandari
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Patient Centered Care ◽  
Care Utilization ◽  
Federal State ◽  
Patient Centered ◽  
Care Experience ◽  
Centered Care ◽  
State And Local ◽  
Privately Insured

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

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