Activating waitlists: Identifying barriers and facilitators to pain self-management while waiting.

IF 1.3 Q4 CLINICAL NEUROLOGY
Lydia V Tidmarsh, Richard Harrison, Harriet Wilkinson, Megan Harrington, Katherine A Finlay
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Abstract

Objectives: Waitlists for pain management services are often extensive, risking psychological and physical decline and patient non-engagement in treatment once accessed. Currently, for outpatient pain management, no standardised waiting list interventions exist, resulting in passive waiting. To arrest prospective wait-related decline(s), this study aimed to identify the barriers and facilitators to pain self-management while waiting, forming the foundation for a waitlist intervention development.

Design: An inductive qualitative approach was utilised to explore the barriers and drivers of pain self-management while waiting for chronic pain management.

Method: Semi-structured interviews, underpinned by the Theoretical Domains Framework and COM-B model, were conducted with people waiting for pain management services (N = 38). Interviews were audio-recorded, transcribed verbatim, and analysed via reflexive thematic analysis.

Results: The analysis demonstrated four thematised barriers and one facilitator: (1) Shunted Around the System (barrier); (2) The Information Gap (barrier); (3) Resisting Adaptation (barrier); (4) Losing Hope (barrier); and (5) Help Yourself or Lose Yourself (facilitator).

Conclusion: This study demonstrates the severe emotional and motivational impact of waiting, increasing treatment disengagement. The waitlist represents a prime opportunity for prehabilitation to protect wellbeing and optimise self-management engagement. Infrastructural and interpersonal barriers of poor communication and healthcare professional pain invalidation must be addressed to improve emotional wellbeing and motivation to engage with planned treatment. Enhancing self-efficacy, pain acceptance, self-compassion, and internal HLOC are fundamental to increasing pain self-management. These can all be met within a prehabilitation framework. This study is foundational for the development of psychological prehabilitation in outpatient chronic pain management.

激活等候名单:识别障碍和促进痛苦的自我管理等待。
目标:等待疼痛管理服务的名单往往很广泛,有心理和身体衰退的风险,病人一旦进入治疗就不参与。目前,对于门诊疼痛管理,没有标准化的等待名单干预存在,导致被动等待。为了阻止预期的等待相关下降,本研究旨在确定等待时疼痛自我管理的障碍和促进因素,为等待名单干预发展奠定基础。设计:采用归纳定性的方法来探索等待慢性疼痛管理时疼痛自我管理的障碍和驱动因素。方法:以理论领域框架和COM-B模型为基础,对等待疼痛管理服务的患者进行半结构化访谈(N = 38)。访谈录音,逐字转录,并通过反身性主题分析进行分析。结果:分析显示了四个主题障碍和一个促进因素:(1)围绕系统分流(障碍);(2)信息鸿沟(障碍);(3)抵抗适应(障碍);(4)失去希望(障碍);(5)帮助你自己或失去你自己(引导者)。结论:本研究证明了等待对情绪和动机的严重影响,增加了治疗脱离。候补名单代表了一个主要的机会,以保护健康和优化自我管理的参与。必须解决沟通不畅和医疗保健专业人员疼痛无效的基础设施和人际障碍,以改善情绪健康和参与计划治疗的动机。增强自我效能、疼痛接受、自我同情和内部HLOC是增强疼痛自我管理的基础。这些都可以在康复框架内得到满足。本研究为心理康复在门诊慢性疼痛治疗中的发展奠定了基础。
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来源期刊
British Journal of Pain
British Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.20
自引率
11.10%
发文量
42
期刊介绍: British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.
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