Integrative pediatric pain management: Impact & implications of a novel interdisciplinary curriculum

"Maybe I would've been more comfortable in my Ignorance?": Exploring future physical therapist's lived experience of an elective pain science course

INTRODUCTION

Through the Master of Physical Therapy program at a Canadian University, Understanding Pain in Rehabilitation (PT9551b) has been an elective option for physical therapy students with the final submission based on a reflective diary. The primary intention of the course is to introduce a critical social science perspective of pain and pain management. A secondary intention is to facilitate student reflection on how they see themselves as 'providers of pain management' or 'providers of physical therapy for people in pain' although at this point, the students' experiences of learning in this way has not been rigorously explored. There has yet to be a systemic examination of how physical therapy students experience learning about pain through such a course, and how the course has impacted their perspectives.

METHOD

This study followed an interpretive phenomenological research design. Single semi-structured in-depth 45-90-minute interviews of recent students were audio recorded and transcribed. In addition, the reflective diaries of students were included in the data set with students' permission. The analysis process followed a detailed reading approach to analysis by reading transcriptions line by line and engaging in critical reflection.

FINDINGS

Six major themes were identified including: 1) Therapeutic Power of Words; 2) Learning through Reflection; 3) Lived Experience with Pain; 4) Patient Partnership; 5) Conceptualizations of Pain; and 6) Pain and Physiotherapy Practice.

CONCLUSION

It is recommended that researchers and educators encourage a continuation of reflective practice to conceptualize new information and as a means for participants to reflect on their personal and professional experiences.

Chronic pain concepts of pediatricians: a qualitative survey

Introduction

Chronic pain is a prevalent, yet underrecognized, condition in children and adolescents. A biopsychosocial framework has been widely adopted over the past decades and resulted in a new pain classification in the International Classification of Diseases, 11th revision (ICD-11). Nevertheless, little is known about pediatricians' pain concepts.

Objectives

We explored pain concepts of Swiss pediatricians by means of a qualitative analysis.

Method

A cross-sectional online survey was sent to clinically active Swiss pediatricians registered with the Swiss Society for Pediatrics. A case vignette of a girl with chronic musculoskeletal pain was presented and pediatricians were asked (1) what they think caused the pain, and (2) how they would explain the pain to the patient and their family. Structuring content analysis was applied to describe major themes within the answers.

Results

The following main categories emerged: psychological factors, biological factors, unclear etiology, social context, disorder specific, and multifactorial. Most pediatricians reported the belief that psychological factors explained the pain. However, when explaining the pain to the patient, biological factors were reported most often.

Conclusion

There is a discrepancy between pediatricians' conviction that chronic pain is mostly explained by psychological factors and their exploratory model towards patients that focuses on biological factors. Promoting the biopsychosocial framework of chronic pain is key to ensure timely and effective treatment. The new pain classification in the ICD-11 has the potential to increase the use of the biopsychosocial model.