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Pain Control: Normalization of the BPCQ Questionnaire on a Group of Patients Diagnosed with Malignant Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413069. [PMID: 34948679 PMCID: PMC8701289 DOI: 10.3390/ijerph182413069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/25/2021] [Accepted: 12/07/2021] [Indexed: 12/24/2022]
Abstract
The purpose of this article is to examine the applicability of the Beliefs about Pain Control Questionnaire (BPCQ) among cancer patients and develop norms that allow differentiation of patients with diagnosed cancer in terms of beliefs about pain control. Normalization aims to establish the value of test results in the study population. The study involved 1187 patients diagnosed with cancer in outpatient care Maria Sklodowska-Curie Cancer Center and Institute of Oncology, in Warsaw. The applied tool was the Beliefs about Pain Control Questionnaire developed by S. Skevington. The results are most strongly differentiated in each dimension of pain control by education, income, and professional status. Sten norms were developed to determine the level of beliefs about pain control in low, average, and high categories. The BPCQ assessment applies to cancer patients, and the assessment of the location of pain control in patients will allow for the identification of patients whose standard therapy should be supplemented with psychotherapeutic support.
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Setchell J, Olson R, Turpin M, Costa N, Barlott T, O'Halloran K, Wigginton B, Hodges P. Afflexivity in post-qualitative inquiry: prioritising affect and reflexivity in the evaluation of a health information website. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:323-338. [PMID: 34520331 DOI: 10.1080/14461242.2021.1976068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
Increasingly, people turn to online sources for health information, creating human-non-human relationalities. Health websites are considered accessible in scope and convenience but can have limited capacity to accommodate complexities. There are concerns about who gets to 'assemble' with these resources, and who is excluded. Guided by Ahmed's socio-political theories of emotions, we questioned our feelings as we intra-acted with a consumer information website about back pain (MyBackPain). This encouraged us to approach resource evaluation in a way that alters conventional rational/cognitive judgement processes. Our inquiry was 'supra-disciplinary' involving public health, sociology, allied health and consumer collaborators. Specifically, we considered relationality - the feelings circulating between bodies/objects and implicated in MyBackPain's affective practices; impressions - the marks, images or beliefs MyBackPain makes on bodies/objects; and directionality - how these intra-actions pushed in some directions and away from others. Although Ahmed would likely not consider herself 'post-humanist', we argue that her socio-political theories of how objects and emotions entangle are of great interest to furthering critical post-human understandings of health. Rather than threatening decision-making, we suggest that feelings (and their affects) are central to it. The article demonstrates the productive potential of critical post-human inquiry in identifying/countering 'othering' possibilities, and catalysing a 'nomadic shift' towards new human-non-human formations.
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Affiliation(s)
- Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rebecca Olson
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - Merrill Turpin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nathalia Costa
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tim Barlott
- School of Social Science, The University of Queensland, Brisbane, Australia
| | | | - Britta Wigginton
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Paul Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Hodges PW, Setchell J, Nielsen M. An Internet-Based Consumer Resource for People with Low Back Pain (MyBackPain): Development and Evaluation. JMIR Rehabil Assist Technol 2020; 7:e16101. [PMID: 32229467 PMCID: PMC7157509 DOI: 10.2196/16101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/15/2019] [Indexed: 01/05/2023] Open
Abstract
People increasingly use the internet to obtain information about health complaints, including low back pain (LBP). LBP is the leading cause of disability internationally, and outcomes are worsening. There is an urgent need for resources that aid improvement of outcomes. There have been calls to engage consumers in the development of resources, but this has rarely been implemented. MyBackPain is a website that was developed with extensive involvement of consumers to ensure that the resource meets their needs for content and presentation. This paper aimed to describe the multistep process undertaken to develop the MyBackPain website and provide an extensive evaluation of its impact. Development of MyBackPain involved 10 steps, many of which have been published in the academic literature. These steps included consultation regarding consumer needs, evaluation of existing internet resources, identification of key messages to be reinforced, identification of frequently asked questions, consensus for content, content development (including development of algorithms to guide tailoring of the user experience), development of consumer-focused evidence-based treatment summaries, development of descriptions of health care providers, and testing. Evaluation included qualitative examination of people's interactions with the website and its effects on their daily lives and an ongoing randomized controlled trial of impact of use of the site on people's LBP-related health literacy, clinical outcomes, and treatment choices. It is hoped that the website can aid in the reduction of the massive burden of LBP and provide a template for the development of resources for other conditions.
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Hall LM, Ferreira M, Setchell J, French S, Kasza J, Bennell KL, Hunter D, Vicenzino B, Dickson C, Hodges P. MyBackPain-evaluation of an innovative consumer-focused website for low back pain: study protocol for a randomised controlled trial. BMJ Open 2019; 9:e027516. [PMID: 31092664 PMCID: PMC6530319 DOI: 10.1136/bmjopen-2018-027516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Despite the prevalence of low back pain (LBP) worldwide, many people with the condition do not receive evidence-based care or achieve the best possible outcomes. There is a gap in the dissemination of evidence-based information across the globe. The advent of the internet has changed the way people obtain health information. As such, trustworthy, tailored and validated LBP resources may help bridge the gap. This study aims to measure the effectiveness of a new website (MyBackPain) in improving spinal health literacy, treatment preferences and clinical outcomes for people with LBP, in comparison with other online resources. METHODS AND ANALYSIS This online, pragmatic, randomised controlled trial will comprise 440 people with non-specific LBP of any duration. In addition to access to publicly available online information (control group), the intervention group will be given access to the MyBackPain.org.au website. Participants and research staff, including the biostatistician, will be blinded to treatment allocation. Data will be collected at baseline, 1, 3 (primary end-point), 6 and 12 months via online surveys and questionnaires. The primary outcome is spinal health literacy. Secondary outcomes include quality of treatment preferences (stated and observed) and LBP clinical outcomes (pain, disability and quality of life). Analyses will be by intention-to-treat and include outcome data on all randomised participants. Descriptive statistics will be presented for demographic and clinical characteristics. ETHICS AND DISSEMINATION This trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry and has ethical approval from the University of Queensland Human Research Ethics Committee (2017000995). Trial outcomes will be shared via national and international conference presentations and peer-reviewed journal publications. TRIAL REGISTRATION NUMBER ACTRN12617001292369; Pre-results.
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Affiliation(s)
- Leanne M Hall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Manuela Ferreira
- Institute of Bone and Joint Research, University of Sydney, Saint Leonards, New South Wales, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Simon French
- Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia
| | - Jessica Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kim L Bennell
- CHESM, University of Melbourne, Parkville, Victoria, Australia
| | - David Hunter
- The University of Sydney, Sydney, New South Wales, Australia
| | - Bill Vicenzino
- Physiotherapy, The University of Queensland, Queensland, Queensland, Australia
| | - Chris Dickson
- Arthritis Australia, Sydney, New South Wales, Australia
| | - Paul Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Mackey LM, Blake C, Casey MB, Power CK, Victory R, Hearty C, Fullen BM. The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study. Physiotherapy 2019; 105:346-353. [PMID: 30878145 DOI: 10.1016/j.physio.2018.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/04/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To establish if health literacy (HL) is linked to poorer outcomes and behaviours in patients with chronic pain. DESIGN A prospective cross-sectional observational study. SETTING Multidisciplinary out-patient pain clinics in three university teaching hospitals. PATIENTS New patients (n=131) referred to the pain clinic with a history of chronic pain (>12 weeks). METHODS A questionnaire was distributed to chronic pain patients attending their first appointment. Those eligible for inclusion were newly referred patients who had pain lasting longer than three months. The questionnaire comprised the following sections: demographics, chronic pain status and disease-related knowledge, quality of life (SF-36), beliefs (Beliefs About Pain Control Questionnaire), and a validated HL tool (Newest Vital Sign). RESULTS Of the 131 participants recruited, 54% had inadequate HL. The group was subsequently stratified according to HL level. In bivariate analysis, inadequate HL was associated with older age (p<0.001), being unemployed or retired (p=0.005), less education (p<0.001), lower income, increased comorbidities (p=0.038), being less likely to utilise allied health services (p=0.001), poorer disease-related knowledge (p=0.002), and poorer beliefs about pain (p<0.05). In multivariate analysis, disease-related knowledge (OR 2.5, 95%CI 1.0 to 6.3, p=0.05) and beliefs about pain (B=-2.3, S.E=0.9, p=0.01) remained independently associated with HL. CONCLUSION Inadequate HL is prevalent in chronic pain patients, and may impact on the development of certain characteristics necessary for effective self-management.
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Affiliation(s)
- Laura M Mackey
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland
| | - Maire-Brid Casey
- Pain Service Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Camillus K Power
- Pain Service, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
| | - Ray Victory
- Pain Service St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Conor Hearty
- Pain Service Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland; UCD Centre for Translational Pain Research, University College Dublin, Ireland.
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Sadeghi R, Heidarnia MA, Zagheri Tafreshi M, Rassouli M, Soori H. The reasons for using acupuncture for pain relief. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15435. [PMID: 25593727 PMCID: PMC4270647 DOI: 10.5812/ircmj.15435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 11/27/2013] [Accepted: 01/22/2014] [Indexed: 12/31/2022]
Abstract
Background: Acupuncture has recently received considerable attention around the world due to its cost-effectiveness, few side effects, and well-established analgesic properties. Objectives: The present study aimed to identify the factors that might lead to using acupuncture for pain relief. Patients and Methods: This qualitative study was conducted using conventional content analysis method. The study population included eight patients and six highly experienced acupuncturists, who were able to express their opinion and were willing to take part in the study. The inclusion criteria for patients were being under treatment with acupuncture for pain relief or a history of treatment during the last year and age > 18 years. All highly trained acupuncturists with minimum of one-year active experience were included. The data were collected via semi-structured in-depth interviews. Categories were extracted through inductive analysis and codes and eventually, themes emerged. Data rigor was assured by data collection triangulation, participants’ variety, and external and members’ check. Results: Initially, 1311 primary codes were extracted, then the related codes were divided into 127 subcategories according to their similarities, and after reduction and integration process, 16 categories were developed from subcategories and eventually five themes were determined, including conventional medicine limitation, efficacy of acupuncture, external promoters, internal promoters, and acupuncture inhibitors. Conclusions: The important factors that affect choosing acupuncture for pain relief included conventional medicine limitations, external promoters, internal promoters, acupuncture efficacy, and acupuncture inhibitors. More interest can be drawn to this technique by basic planning to enhance some of the underlying factors and eliminate obstacles to its further applicability.
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Affiliation(s)
- Roghyeh Sadeghi
- International Branch, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohamad Ali Heidarnia
- Department of Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mohamad Ali Heidarnia, Department of Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9111522291, Fax: +98-2123872567, E-mail:
| | - Mansoure Zagheri Tafreshi
- Department of Management, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Maryam Rassouli
- Department of Pediatrics, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Brown CA, Bostick GP, Lim J, Gross DP. Perceived injustice in injured workers: analysis of public responses to an injured worker who took Workers' Compensation Board employees hostage. Scand J Caring Sci 2012; 26:569-78. [PMID: 22272685 DOI: 10.1111/j.1471-6712.2012.00967.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Injured workers' perceived injustice can contribute to retaliatory, aggressive actions. Research also shows a relationship between persistent pain, anger and aggressive, maladaptive coping. AIMS We took the unique opportunity afforded by a workers compensation board (WCB) hostage taking incident to address four questions: (i) What contemporary values, beliefs, and potential behaviours about the WCB system are reflected in the online postings of other claimants (or family members of claimants) in response to the hostage taking incident? (ii) To what degree do the narratives of people who posted online (PWP) in response to this incident, demonstrate the theme of perceived injustice and support retaliatory actions? (iii) How accurate is the information relayed by PWP about the WCB system where the hostage taking occurred? (iv) What is the quality and the public utility of the information this WCB makes available to the public through on-line posting? METHODS We thematically analysed comments posted on a national news website in response to the hostage-taking. We focused on posted narratives from people who stated that they had personal involvement with WCB. We also assessed the accuracy of the comments about WCB made in these narratives against the information available on the WCB website. A standardized assessment tool was used to determine the readability and accessibility of the WCB website. FINDINGS Emergent themes were: retribution, perceived systemic mistreatment, justice/injustice, empathy, disbelief, and loss. There were many inaccurate beliefs about the Workers' Compensation Board. The overall quality of readability and accessibility of the website was low. CONCLUSION Narratives indicated perceived procedural injustice attributed to a flawed and uncaring compensation system. Inaccurate beliefs about WCB and poor quality of the public website may have contributed to suffering, miscommunication and perceptions of unjust, systemic mistreatment. Findings support a relationship between perceived injustice and aggressive retaliatory action.
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Affiliation(s)
- Cary A Brown
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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Brown CA, Richardson C. Nurses' in the multi-professional pain team: A study of attitudes, beliefs and treatment endorsements. Eur J Pain 2012; 10:13-22. [PMID: 16291294 DOI: 10.1016/j.ejpain.2005.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Accepted: 01/17/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIM It is widely accepted that chronic pain is best treated by a multidisciplinary team. Team approaches are best facilitated if all members understand their own and each others role. Roles and responsibilities have inherent values and beliefs which need to be understood if the team is going to function optimally. Little is known about the attitudes and beliefs of the pain team or the individual professionals within it. All members of the pain team therefore need to critically examine the values and beliefs they bring to these teams. The aim of this study was to start this process for nurses. This was done uniquely by: finding out what components of pain management nurses endorse as important; investigating their beliefs about pain management; and exploring whether nurses' beliefs differ in relation to other service providers. METHOD Data from 103 nurses was extracted from a wider research study of the congruence between what service providers and service users believe to be important treatments for chronic pain. Nurses were surveyed regarding their opinions about which specific treatments or treatment components they would endorse for people with chronic pain. Skevington's Beliefs About Pain Control Questionnaire (BPCQ) was also included. This measured beliefs in three crucial areas; the internal or personal control of pain, beliefs that powerful others (doctors) control pain and beliefs that pain is controlled by chance events. Statistical comparisons were made between nurses who endorsed particular treatments and their belief pattern. Differences between nurses and other professionals and service users were explored. RESULTS The study showed that nurses were high treatment endorsers. There was universal agreement to the importance of 'The nurse', 'The multidisciplinary team', 'relaxation', and 'psychological assessment' for chronic pain management'. Nurses' endorsement patterns were different to the other professionals, because they endorsed more treatments. BPCQ scores were consistently lower than the other professionals and the service users. CONCLUSIONS The findings of this study are congruent with emerging literature highlighting the complexity of health care. The high endorsement patterns seen in this study could be taken as support that nurses are, either tacitly or overtly, aware of this need to approach pain management in an open-minded and flexible manner.
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Affiliation(s)
- Cary A Brown
- Division of Occupational Therapy, School of Health Sciences, University of Liverpool, Johnston Building, Brownlow Hill, Liverpool, UK.
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Stein KV, Dorner TE, Ilias W, Rieder A. [Chronic pain patients and their expectations towards physician care. Results from the Austrian Patient Report]. Schmerz 2011; 24:468-73. [PMID: 20811752 DOI: 10.1007/s00482-010-0962-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The Austrian Patient Report illustrates the preferences of Austrian chronic disease patients for the first time. MATERIAL AND METHODS A standardised, self-administered questionnaire was used with items in the fields of general information, information flow, medicine and health, social and societal aspects and statistics. RESULTS The most important item for Austrian chronic pain patients is a comprehensive discussion with their physician, which is even more important than a reduction in pain intensity. CONCLUSIONS More efforts have to be made to educate and inform chronic pain patients adequately from the doctor's side.
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Affiliation(s)
- K V Stein
- Institut für Sozialmedizin, Zentrum für Public Health, Medizinische Universität Wien, Rooseveltplatz 3, 1090 Wien, Osterreich.
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Meijer EM, Hugenholtz NIR, Sluiter JK, Frings-Dresen MHW. What do referred patients with upper extremity musculoskeletal disorders expect of a multidisciplinary treatment and what is the perceived value? Disabil Rehabil 2009; 30:541-50. [PMID: 17852302 DOI: 10.1080/09638280701355744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To describe reasons for not starting and to determine expectations and perceived value of multidisciplinary treatment among referred patients, sick-listed due to upper extremity musculoskeletal disorders METHOD Twenty-six randomly chosen referred patients who did not start the treatment were interviewed by telephone to identify their reasons for not starting and 24 randomly chosen patients who participated in the treatment were interviewed face-to-face to explore their expectations and experiences of multidisciplinary treatment. RESULTS Reasons for not starting the treatment are mainly intrinsic to the treatment. The most important reason was that the treatment was thought to be too psychological in nature. Most treated patients had no prior expectations but saw it as a last resort for their complaints. The psychological (cognitive-behavioural) component was perceived as the most useful part that acquired the ability to cope with their complaints and developed an increased self-awareness. Most treated patients are satisfied, although some said the treatment did not meet their expectations, because their complaints had not disappeared. CONCLUSION The most important reason for not starting the treatment was the assumption that the treatment is too psychological in nature, while in treated patients the psychological sessions were perceived as most useful treatment component.
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Affiliation(s)
- Eline M Meijer
- Academic Medical Center, Universiteit van Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam, The Netherlands.
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Allcock N, Elkan R, Williams J. Patients referred to a pain management clinic: beliefs, expectations and priorities. J Adv Nurs 2007; 60:248-56. [PMID: 17908123 DOI: 10.1111/j.1365-2648.2007.04400.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study to explore patients' pain-beliefs and emotions at the point of referral to a pain clinic, their expectations of the clinic and their priorities for improvement in aspects of their lives affected by pain. BACKGROUND Chronic pain is a common experience and, although the percentage of people with pain referred to pain clinics is increasing, they often experience complex journeys through the healthcare system. Patients' beliefs about pain have been shown to influence their experience of pain and treatment outcomes, with a focus on the organic cause of pain reported. METHODS Three focus groups were convened with 18 participants. Ten statements about pain were distributed to each participant and ranked according to their priorities. The data were collected in 2002-2003. FINDINGS The participants' beliefs were dominated by the search for a firm diagnosis and cure. Participants held three main beliefs; that the cause of the pain must be established; that other people do not believe in the pain of a person without a firm diagnosis; and that painkillers are a way of 'fobbing you off'. Participants had little knowledge and few concrete expectations of the pain clinic. Their main priorities for improvement were 'less pain', 'some pain free times', and being able to do more 'everyday things'. CONCLUSION Staff delivering pain management services must understand patients' beliefs and expectations and explain their own perspectives in order to provide a sound basis for working together.
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Affiliation(s)
- Nick Allcock
- The University of Nottingham School of Nursing, Queen's Medical Centre, Nottingham, UK.
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Coutu MF, Baril R, Durand MJ, Côté D, Rouleau A. Representations: an important key to understanding workers' coping behaviors during rehabilitation and the return-to-work process. JOURNAL OF OCCUPATIONAL REHABILITATION 2007; 17:522-44. [PMID: 17564819 DOI: 10.1007/s10926-007-9089-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Accepted: 05/17/2007] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Every year many workers are excluded from work because of a work disability attributable to a musculoskeletal disorder (MSD). Factors associated with the development and persistence of the work disability can be related to the worker, work environment, compensation policies, healthcare system and insurance system. Workers' understanding/representations of their disability are associated with coping behaviors aimed at helping them adapt to or solve their health problem. A representation is a complex, organized entity incorporating thoughts, beliefs, and attitudes regarding a particular subject. Representations have been studied in anthropology, sociology and psychology since the 1960s, but often in a compartmentalized way. These representations provide an important key to understanding what motivates workers during rehabilitation and the return-to-work process. To build upon disciplinary knowledge and better understand workers' efforts to cope with their persistent disability, this article therefore aims to pool the different knowledge available on the illness representation concept, from the fields of anthropology, sociology and psychology in order to gain a better understanding of its application in the MSD context. METHODS An electronic literature search (French, English) from 1960 on was conducted in medical, paramedical and social science databases (MedLINE, PsychINFO, CINAHL, etc.) using predetermined key words. After screening abstracts based on a set of criteria, content analysis was performed on the 131 articles retained. RESULTS The theoretical models and approaches can be divided into three categories: (1) personal experience; (2) interactionist; and (3) sociocultural. The models found in sociology and anthropology are mainly descriptive and developed in a medical context, and only rarely in an occupational health context. However, these models could add elements to psychosocial models that are more dynamic and oriented toward understanding the reasons behind specific behaviors. CONCLUSION Bridging the gap between these disciplines will help us achieve a new level of knowledge that will, by taking social interactions into account, enhance understanding of workers' representations, and the behaviors they adopt to manage their MSD-related disability.
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Affiliation(s)
- Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation, Rehabilitation Department, Université de Sherbrooke, 1111 St-Charles Street West, Suite 101, J4K 5G4, Longueuil, QC, Canada.
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