Scandinavian Journal of Pain最新文献

{"title":"What do we know about Indigenous Peoples with low back pain around the world? A topical review.","authors":"Niels Struyf, Tom Vanwing, Wolfgang Jacquet, Nancy Ho-A-Tham, Wim Dankaerts","doi":"10.1515/sjpain-2023-0114","DOIUrl":"10.1515/sjpain-2023-0114","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) represents a worldwide burden with rising disability, especially in low- and middle-income countries. Indigenous Peoples are exposed to many risk factors for LBP and seem to have overall worse health and higher mortality compared to non-Indigenous. This article aims to provide a topical overview of LBP in Indigenous Peoples.</p><p><strong>Methods: </strong>A comprehensive search was done using the keywords \"Indigenous\" and \"back pain.\" Secondly, a cross-reference search of the citations list of the included articles was conducted.</p><p><strong>Results: </strong>LBP is a prevalent, disabling health condition among Indigenous Peoples that impacts activities of daily living, emotional well-being, and cultural identity. Indigenous Peoples face numerous and unique barriers to obtain Western health care. LBP in Indigenous Peoples is partly iatrogenic and available health care lacks a culturally secure setting. In combination with racism and discrimination by health care providers, this leads to miscommunication, frustration, and poor outcome in Indigenous patients around the world.</p><p><strong>Conclusion: </strong>Contextual considerations and interpretation of findings within the appropriate cultural context are needed in future research and treatment of LBP in Indigenous Peoples. However, our literature analysis exhibits disproportionate representation with the scarcity of studies of Indigenous Peoples of Asia and Africa. Addressing this gap in the literature could provide significant scientific value. Indigenous Peoples should not be forgotten in reducing the global burden for LBP.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of deep brain stimulation and verbal suggestions on pain in Parkinson's disease.","authors":"Sophie Rosenkjær, Victor Schwartz Hvingelby, Erik Lisbjerg Johnsen, Mette Møller, Elisa Carlino, Troels Staehelin Jensen, Lene Vase","doi":"10.1515/sjpain-2023-0126","DOIUrl":"10.1515/sjpain-2023-0126","url":null,"abstract":"<p><strong>Background and objectives: </strong>In Parkinson's disease (PD) patients, verbal suggestions have been shown to modulate motor and clinical outcomes in treatment with subthalamic deep brain stimulation (DBS). Furthermore, DBS may alleviate pain in PD. However, it is unknown if verbal suggestions influence DBS' effects on pain.</p><p><strong>Methods: </strong>Twenty-four people with PD and DBS had stimulation downregulated (80-60 to 20%) and upregulated (from 20-60 to 80%) in a blinded manner on randomized test days: (1) with negative and positive suggestions of pain for down- and upregulation, respectively, and (2) with no suggestions to effect (control). Effects of DBS and verbal suggestions were assessed on ongoing and evoked pain (hypertonic saline injections) via 0-10 numerical rating scales along with motor symptoms, expectations, and blinding.</p><p><strong>Results: </strong>Stimulation did not influence ongoing and evoked pain but influenced motor symptoms in the expected direction. Baseline and experimental pain measures showed no patterns in degree of pain. There was a trend toward negative suggestions increasing pain and positive suggestions decreasing pain. Results show significant differences in identical stimulation with negative vs positive suggestions (60% conditions AUC 38.75 vs 23.32, <i>t</i>(13) = 3.10, <i>p</i> < 0.001). Expectations to pain had small to moderate effects on evoked pain. Patients estimated stimulation level correctly within 10 points.</p><p><strong>Conclusion: </strong>Stimulation does not seem to influence ongoing and evoked pain, but verbal suggestions may influence pain levels. Patients appear to be unblinded to stimulation level which is an important consideration for future studies testing DBS in an attempted blind fashion.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare professionals' experiences of interdisciplinary collaboration in pain centres - A qualitative study.","authors":"Torunn Hatlen Nøst, Tone Dahl-Michelsen, Hanne Aandahl, Aslak Steinsbekk","doi":"10.1515/sjpain-2023-0132","DOIUrl":"10.1515/sjpain-2023-0132","url":null,"abstract":"<p><strong>Objectives: </strong>The complexity of chronic pain requires interdisciplinary collaboration. Although this is recognisable in the framework for pain centres, few studies have investigated how interdisciplinary collaboration in pain centres is experienced by healthcare professionals, including the facilitators and barriers to interdisciplinary collaboration. The aim of the current study was therefore to investigate experiences of interdisciplinary collaboration in the treatment of patients with chronic pain among healthcare professionals in tertiary care pain centres.</p><p><strong>Methods: </strong>Eleven healthcare professionals, representing different healthcare disciplines from the four regional pain centres in Norway, participated in semi-structured individual interviews. The data were analysed thematically.</p><p><strong>Results: </strong>The results were categorised into three themes '<i>The best approach for chronic pain treatment'</i>, '<i>Collegial collaboration'</i>, and '<i>Challenges with interdisciplinary teamwork'.</i> The informants valued the interdisciplinary work at the pain centre. They perceived it as the best approach for their patients and appreciated the support the collegial collaboration gave them as professionals. Although working together was rewarding and provided new insights, the informants also experienced the interdisciplinary teamwork as challenging, e.g., when the different professions disagreed on recommendations for further treatment or did not manage to work together as a team.</p><p><strong>Conclusion: </strong>The informants found the interdisciplinary collaboration at the pain centre to provide the best treatment approach for their patients. It should be acknowledged that interdisciplinary teamwork can be challenging, and efforts should be put into establishing a good climate for collaboration and gaining knowledge about each profession's unique character and how they contribute to pain centre treatments.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of hemodynamic parameters and clinical demographic variables with acute postoperative pain in female oncological breast surgery patients: A retrospective cohort study.","authors":"Lieselotte S van Rijbroek, Gerrit J Noordergraaf, Janneke M de Man-van Ginkel, Regina L M van Boekel","doi":"10.1515/sjpain-2023-0066","DOIUrl":"10.1515/sjpain-2023-0066","url":null,"abstract":"<p><strong>Objectives: </strong>Appropriate administration of intraoperative analgesia is an essential factor in care and reasonable recovery times. Inappropriate intraoperative analgesia puts the patient at risk of acute postoperative pain (APOP). The absence of an objective standard for intraoperative nociceptive monitoring complicates pain care. Heart rate (HR) and mean arterial blood pressure (MABP) have been suggested as useful parameters during general anesthesia for nociceptive monitoring. However, studies focusing on whether intraoperative heart rate variability (HRv) and mean arterial blood pressure variability (MABPv) during general anesthesia can accurately monitor nociception in patients have remained inconclusive. The current study aimed to (1) identify the association of intraoperative heart rate and blood pressure variability in patients undergoing low-risk surgery with the incidence of APOP in the immediate postoperative setting and (2) evaluate the associations of clinical demographic factors with the incidence of APOP.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted. The outcome was moderate-to-severe APOP, defined as a numeric rating scale score of <math><mo>≥</mo></math> 4. HRv, MABPv, and potential confounders, such as age, body mass index, duration of surgery, smoking, depression, preoperative use of analgesics, and type of surgery, were used as independent variables.</p><p><strong>Results: </strong>Data from 764 female oncological breast surgery patients were analyzed. No statistically significant association of HRv and MABPv with APOP was found. Lower age was associated with higher odds of APOP (odds ratio [OR] 0.978, <i>p</i> = 0.001). Increased length of surgery (OR 1.013, <i>p</i> = 0.022) and a history of depression were associated with increased odds of APOP (OR 2.327, <i>p</i> = 0.010). The subtype of surgery was statistically significantly associated with APOP (<i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>Our results suggest that heart rate and blood pressure variability intraoperatively, in female patients undergoing low-risk surgery, are not associated with, and thus not predictive of, APOP in the immediate postoperative setting.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain coping and catastrophizing in youth with and without cerebral palsy.","authors":"Michael N Vinkel, Gija Rackauskaite, John R Østergaard, Nanna B Finnerup, Mark P Jensen","doi":"10.1515/sjpain-2023-0062","DOIUrl":"10.1515/sjpain-2023-0062","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to compare the use of pain coping strategies and pain catastrophizing in youth with and without cerebral palsy (CP), and to examine how these two groups differ with respect to the associations between pain coping, catastrophizing, and measures of psychological function and sleep disturbance.</p><p><strong>Methods: </strong>Twenty-seven individuals with CP and 49 healthy controls aged 15-22 were included in this cross-sectional observational study. Pain was assessed using a semi-structured interviews and participants completed measures of pain coping, pain catastrophizing, psychological function, and sleep.</p><p><strong>Results: </strong>Youth with CP used information seeking and problem solving (<i>p</i> = 0.003, Cohen's <i>d</i> (<i>d</i>) = -0.80) and sought social support (<i>p</i> = 0.044, <i>d</i> = -0.51) less often, and used internalizing as a coping strategy more often (<i>p</i> = 0.045, <i>d</i> = 0.59) than healthy controls. The use of information seeking and problem solving correlated more strongly with measures of depression (<i>p</i> = 0.023, Cohen's <i>f</i> (<i>f</i>) <i>=</i> 0.08) and sleep disturbance (<i>p</i> = 0.022, <i>f =</i> 0.08), while behavioral distraction correlated more strongly with measures of anxiety (<i>p</i> = 0.006, <i>f =</i> 0.11) and sleep disturbance (<i>p</i> = 0.017, <i>f =</i> 0.09) in youth with CP, compared to healthy controls.</p><p><strong>Conclusions: </strong>The study findings raise the possibility that youth with CP may benefit more in terms of psychological function and sleep quality from coping training interventions that focus on behavioral distraction, information seeking, and problem solving. Research to test these ideas in additional samples of youth with CP is warranted.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between perfectionism, overactivity, pain severity, and pain interference in individuals with chronic pain: A cross-lagged panel model analysis.","authors":"Kiyoka Enomoto, Jun Sasaki","doi":"10.1515/sjpain-2023-0087","DOIUrl":"10.1515/sjpain-2023-0087","url":null,"abstract":"<p><strong>Objectives: </strong>Overactivity is a characteristic of individuals with chronic pain. Previous cross-sectional studies demonstrated a relationship between perfectionism and overactivity. Therefore, the present study used a longitudinal design to determine whether pain severity and pain interference were exacerbated by overactivity and whether overactivity was exacerbated by perfectionism.</p><p><strong>Methods: </strong>Participants with chronic pain were recruited using crowdsourcing. The participants completed the questionnaires at three time points: T1, T2, and T3 (September, October, and November 2021, respectively). The questionnaire assessed overactivity, perfectionistic strivings, perfectionistic concerns, pain severity, and pain interference. We created cross-lagged panel models to examine the hypothesized relationships among pain, overactivity, and perfectionism.</p><p><strong>Results: </strong>After excluding ineligible participants and invalid response sets, we analyzed the questionnaires completed by 666 participants at T1, 560 at T2, and 554 at T3. The average duration of chronic pain at T1 was 36.35 <i>±</i> 53.53 months. Perfectionistic strivings were partially linked to overactivity, and pain interference was partially related to overactivity. Contrary to our expectations, overactivity did not predict pain severity or pain interference.</p><p><strong>Conclusions: </strong>The hypotheses that perfectionism exacerbates overactivity and that overactivity exacerbates pain severity and pain interference were not supported. These results may have been affected by the quality of the assessment of overactivity. Therefore, further research with a refined evaluation of overactivity is required.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Swedish version of the pain self-efficacy questionnaire short form, PSEQ-2SV: Cultural adaptation and psychometric evaluation in a population of patients with musculoskeletal disorders.","authors":"Annika Ekhammar, Patrik Numanovic, Anna Grimby-Ekman, Maria E H Larsson","doi":"10.1515/sjpain-2023-0059","DOIUrl":"10.1515/sjpain-2023-0059","url":null,"abstract":"<p><strong>Objectives: </strong>Measuring pain self-efficacy is suggested as relevant in patients with musculoskeletal disorders (MSDs) in a primary care setting. However, there is no pain self-efficacy questionnaire (PSEQ) available in Swedish. The aim of this study was to translate and culturally adapt PSEQ-2 to Swedish and evaluate reliability and validity in a population of patients with MSDs.</p><p><strong>Methods: </strong>A translation and cultural adaptation together with psychometric evaluation of reliability and validity were performed according to guidelines with three groups of participants with MSDs. First, a convenient sample of 25 individuals were interviewed in the translation process. Next, 61 participants completed the test-retest survey via social media or QR codes in waiting rooms in rehabilitation clinics. Finally, to evaluate construct validity questionnaires were obtained from 132 participants with MSDs in an ongoing randomized controlled trial.</p><p><strong>Results: </strong>The Swedish version of PSEQ-2 showed adequate face and content validity. The results of 0.805 on Cohen's weighted kappa indicate that the reliability of PSEQ-2SV in a group of adults with MSDs is on the border between substantial and almost perfect. The point estimate regarding relative rank variance, measuring the individual variation within the group, and relative concentration, the systematic change in how the assessments are concentrated on the scale's categories, shows minor systematic differences and some random differences not neglectable. The construct validity of pre-defined hypotheses was met to some degree.</p><p><strong>Conclusion: </strong>The PSEQ-2SV has been accurately linguistically translated and tested for reliability and validity, in a population of MSDs, and is deemed to be able to be used in the clinic and in research. As there were some concerns regarding measurement error and systematic bias, more research could be of value.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Danish version of the knowledge and attitudes survey regarding pain.","authors":"Jacob Brauner Jørgensen, Sanne Lund Clement","doi":"10.1515/sjpain-2023-0140","DOIUrl":"10.1515/sjpain-2023-0140","url":null,"abstract":"<p><strong>Objectives: </strong>Pain management is critical for nurses; therefore, knowledge assessment is also critical. The Knowledge and Attitudes Survey Regarding Pain (KASRP), designed for testing pain management knowledge among nurses, finds widespread use internationally; yet, key validity evidence according to American Psychological Association standards is missing. Therefore, this study aimed to translate and test the psychometric traits of KASRP based on an item response theory model.</p><p><strong>Methods: </strong>Cronbach's <i>α</i> was included to assess internal consistency, and the Kolmogorov-Smirnov test was included to assess the total score normal distribution goodness of fit. KASRP was tested using the Kaiser-Meyer-Olkin (KMO) test for sphericity to examine its suitability for factor analysis and exploratory factor analysis to examine construct evidence. The Kruskal-Wallis <i>H</i> test was used to assess discriminant evidence. The correlation between KASRP and the Brockopp-Warden Pain Knowledge Questionnaire (BWPKQ) was included as a measure of convergent validity evidence, and correlation with self-assessed knowledge was tested as a divergent validity measure.</p><p><strong>Results: </strong>The questionnaire was translated using back-forth and parallel translation. The KMO test for sphericity was 0.49 for all items and 0.53 for the adjusted scale without items 30, 33, and 36, with factor analysis explaining 70.42% of the variation suggesting unacceptable construct validity evidence. Cronbach's <i>α</i> was 0.75, suggesting acceptable reliability evidence; the Kolmogorov-Smirnov test revealed an insignificant skewness of -0.195 and a kurtosis of 0.001, while the Kruskal-Wallis <i>H</i> test revealed a significance of <i>p</i> < 0.001. The correlation between KASRP and the BWPKQ was 0.69 (<i>p</i> = 0.0001), suggesting acceptable convergent validity evidence. A correlation between KASRP and self-assessed knowledge of -0.59 was also found, which suggests acceptable divergent validity evidence.</p><p><strong>Conclusions: </strong>The translated KASRP passed six out of seven tests based on the given sample.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to psychological treatment for chronic cancer-related pain in Sweden.","authors":"Frida Köhler Björkstrand, Joana Duarte, Lance M McCracken, Sean Perrin","doi":"10.1515/sjpain-2023-0074","DOIUrl":"10.1515/sjpain-2023-0074","url":null,"abstract":"<p><strong>Objectives: </strong>Cancer-related pain (CRP) is among the most frequent collateral effects of cancer, with chronic CRP, lasting at least 3 months, affecting >40% of cancer survivors. Evidence-based treatments, including pain-focused cognitive behavioral therapy (CBT), are available, but it appears that cancer patients/survivors are often poorly informed about CRP or the potential benefits of CBT for such pain. This study examined current experience of Swedish cancer patients/survivors in relation to CRP.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 276; 83% female; mean age = 55.5 years, SD = 11.9) were recruited to an online survey via cancer websites in Sweden, and they provided information about their history of chronic CRP and whether they received information about or treatment for CRP from a healthcare professional.</p><p><strong>Results: </strong>Participants had a history of breast (36%), gynecological (12%), lung (10%), colon (8%), and other forms of cancer (36%). A majority (74%) reported a history of chronic CRP and being prescribed analgesic medications (70%). Less than half (47%) received information from their healthcare provider about the risk of CRP and only 13% with chronic CRP received psychological treatment, and of these, only 33% received CBT. Among those receiving psychological treatment for chronic CRP, satisfaction rates were moderate, reported as an average of 6 on a 0-10 scale (standard deviation 2.6).</p><p><strong>Conclusions: </strong>Greater efforts are needed to raise awareness among cancer patients/survivors and healthcare providers about the risk of CRP and evidence-based interventions, including CBT, the first-line intervention for chronic pain. These efforts will need to be matched with increases in treatment capacity, particularly pain-focused CBT.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving general practice management of patients with chronic musculoskeletal pain: Interdisciplinarity, coherence, and concerns.","authors":"Jesper Bie Larsen, Pernille Borregaard, Janus Laust Thomsen, Michael Skovdal Rathleff, Simon Kristoffer Johansen","doi":"10.1515/sjpain-2023-0070","DOIUrl":"10.1515/sjpain-2023-0070","url":null,"abstract":"<p><strong>Objectives: </strong>Management of patients with chronic musculoskeletal pain (CMP) remains a challenge in general practice. The general practitioner (GP) often experiences diagnostic uncertainty despite frequently referring patients with CMP to specialized departments. Therefore, it remains imperative to gain insights on how to optimize and reframe the current setup for the management of patients with CMP. The objective was to explore GP's perspectives on the challenges, needs, and visions for improving the management of patients with CMP.</p><p><strong>Methods: </strong>A qualitative study with co-design using the future workshop approach. Eight GPs participated in the future workshop (five females). Insights and visions emerged from the GP's discussions and sharing of their experiences in managing patients with CMP. The audio-recorded data were subjected to thematic text analysis.</p><p><strong>Results: </strong>The thematic analysis revealed four main themes, including (1) challenges with current pain management, (2) barriers to pain management, (3) the need for a biopsychosocial perspective, and (4) solutions and visions. All challenges are related to the complexity and diagnostic uncertainty for this patient population. GPs experienced that the patients' biomedical understanding of their pain was a barrier for management and underlined the need for a biopsychosocial approach when managing the patients. The GPs described taking on the role of coordinators for their patients with CMP but could feel ill-equipped to handle diagnostic uncertainty. An interdisciplinary unit was recommended as a possible solution to introduce a biopsychosocial approach for the examination, diagnosis, and management of the patient's CMP.</p><p><strong>Conclusions: </strong>The complexity and diagnostic uncertainty of patients with CMP warrants a revision of the current setup. Establishing an interdisciplinary unit using a biopsychosocial approach was recommended as an option to improve the current management for patients with CMP.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}