scholarly journals Role of Health Care Professionals in Multidisciplinary Pain Treatment Facilities in Canada

2008 ◽  
Vol 13 (6) ◽  
pp. 484-488 ◽  
Author(s):  
Philip Peng ◽  
Jennifer N Stinson ◽  
Manon Choiniere ◽  
Dominique Dion ◽  
Howard Intrater ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care Professionals ◽  
Pain Treatment ◽  
Medical Specialty ◽  
Full Time ◽  
Patient Assessment ◽  
Treatment Facilities ◽  
Multidisciplinary Pain Treatment

PURPOSE: To examine the role of health care professionals in multidisciplinary pain treatment facilities (MPTF) for the treatment of chronic pain across Canada.METHODS: MPTF were defined as clinics that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain, and had staff from a minimum of three different health care disciplines (including at least one medical specialty) available and integrated within the facility. Administrative leaders at eligible MPTF were asked to complete a detailed questionnaire on their infrastructure as well as clinical, research, teaching and administrative activities.RESULTS: A total of 102 MPTF returned the questionnaires. General practitioners, anesthesiologists and physiatrists were the most common types of physicians integrated in the MPTF (56%, 51% and 32%, respectively). Physiotherapists, psychologists and nurses were the most common nonphysician professionals working within these MPTF (75%, 68% and 57%, respectively), but 33% to 56% of them were part-time staff. Only 77% of the MPTF held regular interdisciplinary meetings to discuss patient management, and 32% were staffed with either a psychologist or psychiatrist. The three most frequent services provided by physiotherapists were patient assessment, individual physiotherapy or exercise, and transcutaneous electrical nerve stimulation. The three most common services provided by psychologists were individual counselling, cognitive behavioural therapy and psychodynamic therapy. The major roles of nurses were patient assessment, assisting in interventional procedures and patient education.CONCLUSION: Different health care professionals play a variety of important roles in MPTF in Canada. However, few of them are involved on a full-time basis and the extent to which pain is assessed and treated in a truly multidisciplinary manner is questionable.

scholarly journals Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada

2020 ◽  
Vol 45 (12) ◽  
pp. 943-948
Author(s):  
Manon Choinière ◽  
Philip Peng ◽  
Ian Gilron ◽  
Norman Buckley ◽  
Owen Williamson ◽  
...  
Keyword(s):  
Prince Edward Island ◽  
Pain Treatment ◽  
Wait Time ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Online Questionnaire ◽  
Optimal Care ◽  
Cross Sectional ◽  
Treatment Facilities ◽  
Multidisciplinary Pain Treatment

BackgroundMultidisciplinary pain treatment facilities (MPTFs) are considered the optimal settings for the management of chronic pain (CP). This study aimed (1) to determine the distribution of MPTFs across Canada, (2) to document time to access and types of services, and (3) to compare the results to those obtained in 2005–2006.MethodsThis cross-sectional study used the same MPTF definition as in 2005–2006—that is, a clinic staffed with professionals from a minimum of three different disciplines (including at least one medical specialty) and whose services were integrated within the facility. A comprehensive search strategy was used to identify existing MPTFs across Canada. Administrative leads at each MPTF were invited to complete an online questionnaire regarding their facilities.ResultsQuestionnaires were completed by 104 MPTFs (response rate 79.4%). Few changes were observed in the distribution of MPTFs across Canada compared with 12 years ago. Most (91.3%) are concentrated in large urban cities. Prince Edward Island and the Territories still lack MPTFs. The number of pediatric-only MPTFs has nearly doubled but remains small (n=9). The median wait time for a first appointment in publicly funded MPTFs is about the same as 12 years ago (5.5 vs 6 months). Small but positive changes were also observed.ConclusionAccessibility to public MPTFs continues to be limited in Canada, resulting in lengthy wait times for a first appointment. Community-based MPTFs and virtual care initiatives to distribute pain services into regional and remote communities are needed to provide patients with CP with optimal care.

Identifying and Assessing Overlapping Chronic Pain and Mental Illness

2020 ◽  
pp. 79-91
Author(s):  
Glenn J. Treisman
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Mental Illness ◽  
Health Care Professionals ◽  
Life Skills ◽  
Pain Treatment ◽  
Functional Rehabilitation ◽  
Clinical Appearance ◽  
Limited Life ◽  
Psychiatric Conditions

Psychiatric comorbidity profoundly affects outcomes in chronic pain. Chronic pain alters the clinical appearance of psychiatric conditions. Problems of poor coping, limited life skills, poor social and behavioral modeling, limited resources, and poor self-efficacy all can complicate and exacerbate chronic pain disorders. Operant and classical mechanisms with inadvertent rewards for illness-related behaviors condition the behaviors associated with chronic pain. Iatrogenic addiction can also make it difficult for patients to engage in functional rehabilitation. Features of temperament, including extraversion and instability, lead to maladaptive responses to managing pain and difficulty engaging with physicians and health care professionals. Lastly, diseases of mood decrease the normal capacity to experience rewards associated with healthy behavior and divert patients toward avoidance coping, nihilistic views of recovery, and disengagement from support systems and medical care. A coherent and comprehensive diagnostic formulation including these elements leads to effective interdisciplinary rehabilitative pain treatment.

scholarly journals ‘A lifebuoy’ and ‘a waste of time’: patients’ varying experiences of multidisciplinary pain centre treatment- a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Torunn Hatlen Nøst ◽  
Aslak Steinsbekk
Keyword(s):  
Chronic Pain ◽  
Qualitative Study ◽  
Multidisciplinary Approach ◽  
Pain Treatment ◽  
Multidisciplinary Treatment ◽  
Individual Interviews ◽  
Multidisciplinary Assessment ◽  
Pain Centre ◽  
Treatment Facilities ◽  
Multidisciplinary Pain Treatment

Abstract Background The recognition of chronic pain as a biopsychosocial phenomenon has led to the establishment of multidisciplinary pain treatment facilities, such as pain centres. Previous studies have focussed on inpatient, group-based or time-limited multidisciplinary pain programmes. The aim was to investigate variation in patients’ experiences of attending individual outpatient multidisciplinary treatment at pain centres in Norway. Methods This was a qualitative study using semi-structured individual interviews with 19 informants. The informants were recruited among persons who after referral by their general practitioners 12 months prior had attended multidisciplinary pain treatment at a pain centre. The data were analysed thematically using systematic text condensation. Results The informants had received different treatments at the pain centres. Some had undergone only one multidisciplinary assessment in which a physician, a psychologist and a physiotherapist had been present, whereas others had initially been to a multidisciplinary assessment and then continued treatment by one or more of the professionals at the centre. Their experiences ranged from the pain centre as being described as a lifebuoy by some informants who had attended treatment over time, to being described as a waste of time by others who had only attended one or two multidisciplinary sessions. Prominent experiences included being met with understanding and a perception of receiving the best possible treatment, but also included disappointment over not being offered any treatment and perceiving the multidisciplinary approach as unnecessary. Conclusions There were large variations in the informants’ experiences in the pain centres. The findings indicate that the pain centres’ multidisciplinary approach can represent a new approach to living with chronic pain but may also not provide anything new. Efforts should be devoted to ensuring that the pain centres’ multidisciplinary treatment approach is aligned with their patients’ actual needs.

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.

Problematic Prescription Opioid Use in a Chronic Pain Treatment Facility: The Role of Emotional Processes

2018 ◽  
Vol 54 (3) ◽  
pp. 495-505 ◽  
Author(s):  
Lindsay M. S. Oberleitner ◽  
Mark A. Lumley ◽  
Emily R. Grekin ◽  
Kathryn M. Z. Smith ◽  
Amy M. Loree ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Treatment Facility ◽  
Emotional Processes ◽  
Chronic Pain Treatment ◽  
Prescription Opioid Use

The Role of Primary Health Care Professionals

2017 ◽  
pp. 329-335 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Héctor R. Martínez-Ramírez ◽  
Laura Cortés-Sanabria ◽  
Enrique Rojas-Campos
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Primary Health

scholarly journals Optogenetics and photopharmacology in pain research and therapeutics

STEMedicine ◽  
2020 ◽  
Vol 1 (3) ◽  
pp. e43 ◽  
Author(s):  
Federico Iseppon ◽  
Manuel Arcangeletti
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Molecular Switches ◽  
Genetic Profiling ◽  
Pain Research ◽  
Recent Advances ◽  
Cellular Components ◽  
The Brain

Pain afflicts billions of people worldwide, who suffer especially from long-term chronic pain. This gruelling condition affects the nervous system at all levels: from the brain to the spinal cord, the Dorsal Root Ganglia (DRG) and the peripheral fibres innervating the skin. The nature of the different molecular and cellular components of the somatosensory modalities, as well as the complexity of the peripheral and central circuitry are yet poorly understood. Light-based techniques such as optogenetics, in concert with the recent advances in single-cell genetic profiling, can help to elucidate the role of diverse neuronal sub-populations in the encoding of different sensory and painful stimuli by switching these neurons on and off via optically active proteins, namely opsins.  Recently, photopharmacology has emerged from the efforts made to advance optogenetics. The introduction of azo-benzene-based light-sensitive molecular switches has been applied to a wide variety of molecular targets, from ion channels and receptors to transporters, enzymes and many more, some of which are paramount for pain research and therapy. In this Review, we summarise the recent advances in the fields of optogenetics and photopharmacology and we discuss the use of light-based techniques for the study of acute and chronic pain physiology, as well as their potential for future therapeutic use to improve pain treatment.

scholarly journals The Efficacy of an Antioppression Curriculum for Health Professionals

2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  
Keyword(s):  
Health Care ◽  
Teaching Methods ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Care Disparities ◽  
Unconscious Bias ◽  
Survey Response Rate ◽  
The Mean ◽  
Skill Building

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d>0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.

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