'Talk to us like we're people, not an X-ray': the experience of receiving care for chronic pain

2013 ◽  
Vol 19 (2) ◽  
pp. 138 ◽  
Author(s):  
Mandy Nielsen ◽  
Michele Foster ◽  
Paul Henman ◽  
Jenny Strong
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Provider Communication ◽  
Convenience Sample ◽  
X Ray ◽  
Individual Level ◽  
Health Care Experiences ◽  
Patient Provider Communication ◽  
The Individual ◽  
The Impact

Chronic pain is a commonly reported problem in primary care, and is Australia’s third most costly health problem. Despite advances in the understanding and treatment of pain, many people with chronic pain do not receive the best available care. This paper examines the health care experiences of people with chronic pain and focuses discussion on the impact that institutional and cultural factors can have on individual experience. Unstructured narrative interviews were conducted with a convenience sample of 20 people with chronic pain. Participants’ experiences pointed to several factors that can affect the outcome of the health care they receive, including: the belief that all pain is due to identifiable injury or disease; a commitment to finding a diagnosis and cure; problematic patient−provider communication; and poor integration of health services. Comprehensively addressing these factors cannot be achieved by focusing interventions at the individual level. A multifaceted response, which includes public health and systemic initiatives, is required.

Personal responsibility for health: the impact of digitalisation

2019 ◽  
Vol 7 (3) ◽  
pp. 241-258
Author(s):  
Andrea Martani ◽  
Georg Starke
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Personal Responsibility ◽  
Health Care Systems ◽  
Individual Level ◽  
Fine Grained ◽  
Care Systems ◽  
Gerald Dworkin ◽  
The Individual ◽  
The Impact

Fostering the personal responsibility of patients is often considered a potential remedy for the problem of resource allocation in health care systems. In political and ethical debates, systems of rewards and punishments based on personal responsibility have proved very divisive. However, regardless of the controversies it has sparked, the implementation of personal responsibility in concrete policies has always encountered the problem of practical enforceability, i.e.how causally relevant behaviour can be tracked, allowing policies of this kind to be applied in a fine-grained, economically viable and accurate fashion. In this paper, we show how this hurdle can be seemingly overcome with the advent of digitalisation in health and delineate the potential impact of digitalisation on personal responsibility for health. We discuss how digitalisation – by datafying health and making patients transparent – promises to close the loophole of practical enforceability by allowing to trace health-related lifestyle choices of individuals as well as their exposure to avoidable risk factors. Digitalisation in health care thereby reinforces what Gerald Dworkin has called the causal aspect of personal responsibility and strengthens the implicit syllogism that – since exposure to risk factors happens at the individual level – responsibility for health should be ascribed to the individual. We conclude by addressing the limitations of this approach and suggest that there are other ways in which the potential of digitalisation can help with the allocation of resources in health care.

Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction

2015 ◽  
Vol 8 (1) ◽  
pp. 50-50 ◽  
Author(s):  
T. Jonsdottir ◽  
S. Gunnarsdottir ◽  
H. Jonsdottir
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Daily Life ◽  
Demographic Variables ◽  
Provider Communication ◽  
Related Quality ◽  
Health Related ◽  
Patient Provider Communication ◽  
And Control

Abstract Aims To investigate patients’ perception of chronic pain related patient-provider communication in relation to socio-demographic and pain-related variables. Methods Apostal questionnaire measuring socio-demographic variables, pain characteristics, health-related quality of life (HRQoL), pain-related health care utilization and perceived patient provider communication, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. Relationships between patient perceived patient-provider communication and perceived outcome, satisfaction with care as well as sociodemographic and pain-related variables were tested by using bivariate and multivariate statistical analysis. Results The prevalence of chronic pain (≥3months) among respondents was 47.5%. Among participants reporting chronic pain, 53.2% had consulted a health care provider for pain during the previous six months. Patients’ perception of providers’ behaviour and control in the communication was mostly related to pain impact on daily life and physical components of HRQoL as well as to patients’ satisfaction with health care providers. The more pain interfered with daily life and impaired patients’ physical health, the more they felt that the provider did not spend time to listen to their concerns and discuss symptoms and treatment options. Patients’ perception of own activity and control in the patient-provider communication and participation in care was related to socio-demographic variables but not with pain related variables. Conclusions To be understood as an individual and having their concerns legitimized by the health care provider is crucial for patients when consulting health care for chronic pain. The more pain interferes with daily life and impairs HRQoL, the more important this is. Patients’ perception of own control in patient-provider communication and participation in care is more related to socio-demographics than pain related variables.

scholarly journals Improving Outcomes for Hospitalized Patients Pre- and Post-COVID-19

2020 ◽  
Vol 5 (6) ◽  
pp. 1577-1585
Author(s):  
Richard R. Hurtig ◽  
Rebecca Alper ◽  
Tami Altschuler ◽  
Sarah Gendreau ◽  
Jessica Gormley ◽  
...  
Keyword(s):  
Health Care ◽  
Assistive Technology ◽  
Patient Outcomes ◽  
Provider Communication ◽  
Care Providers ◽  
Communication Tools ◽  
Number Of Patients ◽  
Technology Intervention ◽  
Patient Provider Communication ◽  
The Impact

Purpose Barriers to effective patient–provider communication increase the risk that a patient will experience a hospital-acquired condition (HAC) that will negatively impact the patient's health outcomes. Providing patients with communication tools can significantly reduce the risks of experiencing HACs. This article describes how barriers to effective patient–provider communication can impact patient outcomes and reports on the incidence of HACs in patients who received assistive technology to address barriers to patient–provider communication. This topic is of critical relevance, as the COVID-19 pandemic has dramatically increased the number of patients who face communication barriers and the accompanying challenges encountered by their health care providers. Method/Approach The researchers compared the number of expected HACs based on previously obtained data to the number of HACs reported among patients who received an assistive technology intervention. Additionally, the impact of COVID-19 on patient–provider communication was discussed through the provision of case descriptions from frontline speech-language pathologists who have worked in COVID-19 intensive care units. Results The patients who received the assistive technology intervention had a significantly lower incidence of HACs than what would be expected in hospital settings. Clinicians working directly with patients with COVID-19 identified suggestions on how both patients and providers can address the barriers to effective patient–provider communication. Conclusion A key to better patient outcomes and lower health care costs will require making the provision of communication tools part of the standard of care for all patients facing barriers to communication.

Improving Patient Safety and Patient–Provider Communication

2019 ◽  
Vol 4 (5) ◽  
pp. 1017-1027 ◽  
Author(s):  
Richard R. Hurtig ◽  
Rebecca M. Alper ◽  
Karen N. T. Bryant ◽  
Krista R. Davidson ◽  
Chelsea Bilskemper
Keyword(s):  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Health Care Team ◽  
Provider Communication ◽  
Alternative Communication ◽  
Patient Provider Communication ◽  
Acute Care Settings ◽  
Nurses Perceptions ◽  
Communication Needs ◽  
The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

scholarly journals Natural History of NAFLD

2021 ◽  
Vol 10 (6) ◽  
pp. 1161
Author(s):  
Raluca Pais ◽  
Thomas Maurel
Keyword(s):  
Liver Disease ◽  
Natural History ◽  
Disease Progression ◽  
Specific Treatment ◽  
Alcoholic Fatty Liver ◽  
Individual Level ◽  
Close Relationship ◽  
History Of ◽  
The Individual ◽  
The Impact

The epidemiology and the current burden of chronic liver disease are changing globally, with non-alcoholic fatty liver disease (NAFLD) becoming the most frequent cause of liver disease in close relationship with the global epidemics of obesity, type 2 diabetes and metabolic syndrome. The clinical phenotypes of NAFLD are very heterogeneous in relationship with multiple pathways involved in the disease progression. In the absence of a specific treatment for non-alcoholic steatohepatitis (NASH), it is important to understand the natural history of the disease, to identify and to optimize the control of factors that are involved in disease progression. In this paper we propose a critical analysis of factors that are involved in the progression of the liver damage and the occurrence of extra-hepatic complications (cardiovascular diseases, extra hepatic cancer) in patients with NAFLD. We also briefly discuss the impact of the heterogeneity of the clinical phenotype of NAFLD on the clinical practice globally and at the individual level.

scholarly journals Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerardo Chowell ◽  
Sushma Dahal ◽  
Raquel Bono ◽  
Kenji Mizumoto
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
Contact Network ◽  
Social Distancing ◽  
Individual Level ◽  
Health Measures ◽  
Testing Strategies ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review

2022 ◽  
pp. 105984052110681
Author(s):  
Ashwini R. Hoskote ◽  
Emily Croce ◽  
Karen E. Johnson
Keyword(s):  
Mental Health ◽  
Adolescent Mental Health ◽  
School Nurse ◽  
School Nurses ◽  
Integrative Review ◽  
School Nursing ◽  
Individual Level ◽  
The Individual ◽  
The Impact

School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.

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