Meta-ethnography to understand healthcare professionals’ experience of treating adults with chronic non-malignant pain

ObjectivesWe aimed to explore healthcare professionals’ experience of treating chronic non-malignant pain by conducting a qualitative evidence synthesis. Understanding this experience from the perspective of healthcare professionals will contribute to improvements in the provision of care.DesignQual...

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Bibliographic Details
Published in:BMJ open Vol. 7; no. 12; p. e018411
Main Authors: Toye, Francine, Seers, Kate, Barker, Karen L
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 21.12.2017
BMJ Publishing Group
Subjects:
Adult
Anthropology, Cultural
Back pain
Bibliographic data bases
Chronic Pain - ethnology
Chronic Pain - therapy
Curricula
Ethnography
Family physicians
Health Knowledge, Attitudes, Practice - ethnology
Health Personnel
Humans
Interviews
Medical personnel
Narcotics
Pain Management
Patients
Primary care
Qualitative Research
Research methodology
Subject heading schemes
Systematic review
Young adults
United Kingdom > UK
United States > US
pain management
meta-ethnography
qualitative evidence synthesis
qualitative research
healthcare professionals
ISSN:2044-6055, 2044-6055
Online Access:Get full text
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Summary:ObjectivesWe aimed to explore healthcare professionals’ experience of treating chronic non-malignant pain by conducting a qualitative evidence synthesis. Understanding this experience from the perspective of healthcare professionals will contribute to improvements in the provision of care.DesignQualitative evidence synthesis using meta-ethnography. We searched five electronic bibliographic databases from inception to November 2016. We included studies that explore healthcare professionals’ experience of treating adults with chronic non-malignant pain. We used the GRADE-CERQual framework to rate confidence in review findings.ResultsWe screened the 954 abstracts and 184 full texts and included 77 published studies reporting the experiences of over 1551 international healthcare professionals including doctors, nurses and other health professionals. We abstracted six themes: (1) a sceptical cultural lens, (2) navigating juxtaposed models of medicine, (3) navigating the geography between patient and clinician, (4) challenge of dual advocacy, (5) personal costs and (6) the craft of pain management. We rated confidence in review findings as moderate to high.ConclusionsThis is the first qualitative evidence synthesis of healthcare professionals’ experiences of treating people with chronic non-malignant pain. We have presented a model that we developed to help healthcare professionals to understand, think about and modify their experiences of treating patients with chronic pain. Our findings highlight scepticism about chronic pain that might explain why patients feel they are not believed. Findings also indicate a dualism in the biopsychosocial model and the complexity of navigating therapeutic relationships. Our model may be transferable to other patient groups or situations.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2017-018411