Barriers and enablers influencing healthcare professionals' adoption of a biopsychosocial approach to musculoskeletal pain

Pain ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wendy Ng ◽  
Helen Slater ◽  
Cobie Starcevich ◽  
Anthony Wright ◽  
Tim Mitchell ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Healthcare Professionals ◽  
Biopsychosocial Approach ◽  
Barriers And Enablers

Perspectives of implementing the biopsychosocial model to treat chronic musculoskeletal pain in primary health care

2020 ◽  
Author(s):  
Cláudio Gregório Nuernberg Back ◽  
Richard Eloin Liebano ◽  
Mariana Arias Avila
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Musculoskeletal Pain ◽  
Biopsychosocial Model ◽  
Healthcare Professionals ◽  
Chronic Musculoskeletal Pain ◽  
Biopsychosocial Approach ◽  
Unified Health System ◽  
Primary Health ◽  
The Common

Aim: To propose actions to organize healthcare of people with chronic musculoskeletal pain (CMP) into a biopsychosocial approach. Materials & methods: Narrative overview with the Brazilian Unified Health System as archetype to propose the implementation of a biopsychosocial approach to manage CMP. Results: Healthcare systems often use biomedical model for CMP management, which may explain the increase of demand and costs of CMP management. This is significant in Primary Health Care, where the healthcare professionals have difficulty with evaluating and treating psychosocial factors. Conclusion: The present perspective selected some actions that are part of the common procedures in Brazil’s Primary Health Care and proposed a protocol of amplified care for CMP management in all levels: orientation, health promotion, prevention and rehabilitation.

Prevalence of Work-related Musculoskeletal Elbow Pain Among Healthcare Professionals of Lahore City

2020 ◽  
pp. 3-7
Author(s):  
OJS Admin
Keyword(s):  
Musculoskeletal Pain ◽  
Healthcare Professionals ◽  
Elbow Pain ◽  
Work Related ◽  
Common Complaint ◽  
The Common ◽  
Lahore City

Musculoskeletal pain is very common complaint in the workplace and about billions of dollars yearly are spending on work-related musculoskeletal issue. Elbow pain is one of the common complaints in healthcare professionals nowadays. Few studies have been conducted on musculoskeletal pain among healthcare professionals in Pakistan, but not specifically on elbow pain.

Barriers and enablers to delivering preventative and early intervention footcare to people with diabetes: a scoping review of healthcare professionals' perceptions

2019 ◽  
Vol 25 (6) ◽  
pp. 517 ◽  
Author(s):  
Leanne Mullan ◽  
Andrea Driscoll ◽  
Karen Wynter ◽  
Bodil Rasmussen
Keyword(s):  
Primary Care ◽  
Early Intervention ◽  
English Language ◽  
Healthcare Professionals ◽  
Implementation Challenges ◽  
Barriers And Enablers ◽  
Primary Care Health ◽  
Care Health ◽  
Foot Disease ◽  
Definition Of

The aim of this study is to examine barriers and enablers to delivering preventative and early intervention footcare to people with diabetes, from the perspective of healthcare professionals within primary care. MEDLINE, CINAHL and Scopus databases, as well as Google Scholar, were searched in September 2018. Inclusion criteria included: English language, qualitative and quantitative studies, since 1998, reporting on barriers or enablers, as reported by primary care health professionals, to delivering preventative or early intervention footcare to people with diabetes. In total, 339 studies were screened. Eight studies met criteria. Perceived barriers to providing footcare included: geographical, administrative and communication factors; referral and care guideline availability and implementation challenges; limited availability of specialists and high-risk foot services; and limited resources including time and funding. Enablers to footcare were: implementation of footcare programs; education; clear definition of staff roles; development of foot assessment reminder systems; and reminders for people with diabetes to remove their shoes at appointments. Barriers and enablers to footcare are multifaceted. Healthcare professionals are affected by health system and individual factors. By implementing strategies to address barriers to footcare delivery, it is possible to improve outcomes for people with diabetes, thus reducing the effect of diabetes-related foot disease.

scholarly journals The (cost-)effectiveness and cost-utility of a novel integrative care initiative for patients with chronic musculoskeletal pain: the pragmatic trial protocol of Network Pain Rehabilitation Limburg

2020 ◽  
Author(s):  
Cynthia Lamper ◽  
Ivan PJ Huijnen ◽  
Mariëlle EJB Goossens ◽  
Bjorn Winkens ◽  
Dirk Ruwaard ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Musculoskeletal Pain ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Cost Utility ◽  
Chronic Musculoskeletal Pain ◽  
Local Networks ◽  
Quadruple Aim ◽  
The Cost

Abstract Background: Rehabilitation care for patients with chronic musculoskeletal pain (CMP) is not optimally organized. The Network Pain Rehabilitation Limburg 2.0 (NPRL2.0) provides integrated care with a biopsychosocial approach and strives to improve the Quadruple Aim outcomes: pain-related disability of patients with CMP; experiences of care of patients with CMP; meaning in the work of healthcare professionals; and healthcare costs. Firstly, in this study, the effectiveness (with regard to the functioning and participation of patients) of primary care for patients with CMP will be assessed, comparing care organized following the NPRL2.0 procedure with usual care. Secondly, the cost-effectiveness and cost-utility with regard to health-related quality of life and healthcare costs will be assessed. And thirdly, the effect of duration of participation in a local network in primary care will be studied. Methods: In this pragmatic study, it is expected that two local networks with 105 patients will participate in the prospective cohort study and six local networks with 184 patients in the stepped-wedge based design. Healthcare professionals in the local networks will recruit patients. Inclusion criteria: age ≥ 18 years; having CMP; willing to improve functioning despite pain; and adequate Dutch literacy. Exclusion criteria: pregnancy; and having a treatable medical or psychiatric disease. Patients will complete questionnaires at baseline (T1), 3 months (T2), 6 months (T3), and 9 months (T4). Questionnaires at T1 and T4 will include the Pain Disability Index and Short Form Health Survey. Questionnaires at T1, T2, T3, and T4 will include the EQ-5D-5L, and iMTA Medical Consumption and Productivity Cost Questionnaires. Outcomes will be compared using linear mixed-model analysis and costs will be compared using bootstrapping methods. Discussion: NPRL2.0 is a multidimensional, complex intervention, executed in daily practice, and therefore needing a pragmatic study design. The current study will assess NPRL2.0 with respect to the Quadruple Aim outcomes: patient health and costs. This will provide more information on the (cost-) effectiveness of the organization of care in a network structure regarding patients with CMP. The other two Quadruple Aim outcomes will be examined alongside this study. Trial registration: Netherlands Trial Register: NL7643

scholarly journals The (cost-)effectiveness and cost-utility of a novel integrative care initiative for patients with chronic musculoskeletal pain: the pragmatic trial protocol of Network Pain Rehabilitation Limburg

2020 ◽  
Author(s):  
Cynthia Lamper ◽  
Ivan PJ Huijnen ◽  
Mariëlle EJB Goossens ◽  
Bjorn Winkens ◽  
Dirk Ruwaard ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Musculoskeletal Pain ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Cost Utility ◽  
Chronic Musculoskeletal Pain ◽  
Local Networks ◽  
Quadruple Aim ◽  
The Cost

Abstract Background: Rehabilitation care for patients with chronic musculoskeletal pain (CMP) is not optimally organized. The Network Pain Rehabilitation Limburg 2.0 (NPRL2.0) provides integrated care with a biopsychosocial approach and strives to improve the Quadruple Aim outcomes: pain-related disability of patients with CMP; experiences of care of patients with CMP; meaning in the work of healthcare professionals; and healthcare costs. Firstly, in this study, the effectiveness (with regard to the functioning and participation of patients) of primary care for patients with CMP will be assessed, comparing care organized following the NPRL2.0 procedure with usual care. Secondly, the cost-effectiveness and cost-utility with regard to health-related quality of life and healthcare costs will be assessed. And thirdly, the effect of duration of participation in a local network in primary care will be studied. Methods: In this pragmatic study, it is expected that two local networks with 105 patients will participate in the prospective cohort study and six local networks with 184 patients in the stepped-wedge based design. Healthcare professionals in the local networks will recruit patients. Inclusion criteria: age ≥ 18 years; having CMP; willing to improve functioning despite pain; and adequate Dutch literacy. Exclusion criteria: pregnancy; and having a treatable medical or psychiatric disease. Patients will complete questionnaires at baseline (T1), 3 months (T2), 6 months (T3), and 9 months (T4). Questionnaires at T1 and T4 will include the Pain Disability Index and Short Form Health Survey. Questionnaires at T1, T2, T3, and T4 will include the EQ-5D-5L, and iMTA Medical Consumption and Productivity Cost Questionnaires. Outcomes will be compared using linear mixed-model analysis and costs will be compared using bootstrapping methods. Discussion: NPRL2.0 is a multidimensional, complex intervention, executed in daily practice, and therefore needing a pragmatic study design. The current study will assess the NPRL2.0 with respect to the Quadruple Aim’s outcomes of effectiveness of healthcare and economic consequences. The other two Quadruple Aim outcomes will be examined alongside this study, providing a broad scope of the performance of NPRL2.0. Trial registration: Netherlands Trial Register: NL7643; Registered 5 April 2019. https://www.trialregister.nl/trial/7643

scholarly journals Barriers and Enablers to Physical Activity in Patients during Hospital Stay: A Scoping Review

2021 ◽  
Author(s):  
Sven Jacobus Gertruda Geelen ◽  
Hanneke Corine van Dijk - Huisman ◽  
Robert Adriaan de Bie ◽  
Cindy Veenhof ◽  
Raoul Engelbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Healthcare Professional ◽  
Hospital Stay ◽  
Acute Care ◽  
Scoping Review ◽  
Healthcare Professionals ◽  
Social Influences ◽  
Comprehensive Overview ◽  
Barriers And Enablers

Abstract Background: Low levels of physical activity are common during hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during hospital stay for acute care, using the Theoretical Domains Framework (TDF). Methods: We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO and Cochrane library (inception to September 2020), which included quantitative, qualitative and mixed-methods studies reporting barriers and enablers to physical activity during hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded and categorized all barriers and enablers into TDF domains.Results: Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54).Conclusions: Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during hospital stay, and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients’ physical activity behaviour. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation.Registration: No protocol was registered for this review.

scholarly journals Lived experiences of informal caregivers of people with chronic musculoskeletal pain: a systematic review and meta-ethnography

2020 ◽  
pp. 204946372092511
Author(s):  
Toby Smith ◽  
Jessica Fletcher ◽  
Sarah Lister
Keyword(s):  
Lived Experience ◽  
Musculoskeletal Pain ◽  
Lived Experiences ◽  
Healthcare Professionals ◽  
Informal Caregivers ◽  
Role Reversal ◽  
Chronic Musculoskeletal Pain ◽  
Care Recipient ◽  
Clinical Trial Registry ◽  
Care Recipients

Background: People with chronic pain often seek support from friends and family for everyday tasks. These individuals are termed informal caregivers. There remains uncertainty regarding the lived experiences of these people who care for individuals with chronic musculoskeletal pain. The aim of this article is to synthase the evidence on the lived experiences of informal caregivers providing care to people with chronic musculoskeletal pain. Methods: A systematic literature review was undertaken of published and unpublished literature databases including EMBASE, MEDLINE, CINAHL, PubMed, the WHO International Clinical Trial Registry and ClinicalTrials.gov registry (to September 2019). Qualitative studies exploring the lived experiences of informal caregivers of people with chronic musculoskeletal pain were included. Data were synthesised using a meta-ethnography approach. Evidence was evaluated using the Critical Appraisal Skills Programme qualitative appraisal tool. Results: From 534 citations, 10 studies were eligible (360 participants: 171 informal caregivers of 189 care recipients). The evidence was moderate quality. Seven themes arose: the relationship of caregivers to healthcare professionals; role reversal with care recipients; acting the confidant to the care recipient; a constant burden in caregiving; legitimising care recipient’s condition; knowledge and skills to provide caregiving; and the perception of other family members and wider society to the caregiver/care recipient dyad. Conclusion: The lived experiences of caregivers of people with chronic musculoskeletal pain is complex and dynamic. There is an inter-connected relationship between caregivers, care recipients and healthcare professionals. Exploring how these experiences can be modified to improve a caregiving dyad’s lived experience is now warranted.

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