Understanding how primary care clinicians make sense of chronic pain

Understanding how primary care clinicians make sense of chronic pain Chronic pain leads to reduced quality of life for patients, and strains health systems worldwide. In the US and some other countries, the complexities of caring for chronic pain are exacerbated by individual and public health risks associated with commonly used opioid analgesics. To help understand and improve pain care, this article uses the data frame theory of sensemaking to explore how primary care clinicians in the US manage their patients with chronic noncancer pain. We conducted Critical Decision Method interviews with ten primary care clinicians about 30 individual patients with chronic pain. In these interviews, we identified several patients, social/environmental, and clinician factors that influence the frames clinicians use to assess their patients and determine a pain management plan. Findings suggest significant ambiguity and uncertainty in clinical pain management decision making. Therefore, interventions to improve pain care might focus on sup- porting sensemaking in the context of clinical evidence rather than attempting to provide clinicians with decontextualized and/or algorithm-based decision rules. Interventions might focus on delivering convenient and easily interpreted patient and social/environmental information in the context of clinical practice guidelines. Keywords Sensemaking · Health · Primary care · Chronic pain · Decision making · Opioids 1 Introduction United States (US), the majority http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png "Cognition, Technology & Work" Springer Journals

Understanding how primary care clinicians make sense of chronic pain

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer-Verlag London Ltd., part of Springer Nature
Subject
Computer Science; User Interfaces and Human Computer Interaction; Industrial and Organizational Psychology; Cognitive Psychology; Automotive Engineering; Aerospace Technology and Astronautics; Medicine/Public Health, general
ISSN
1435-5558
eISSN
1435-5566
D.O.I.
10.1007/s10111-018-0491-1
Publisher site
See Article on Publisher Site

Abstract

Chronic pain leads to reduced quality of life for patients, and strains health systems worldwide. In the US and some other countries, the complexities of caring for chronic pain are exacerbated by individual and public health risks associated with commonly used opioid analgesics. To help understand and improve pain care, this article uses the data frame theory of sensemaking to explore how primary care clinicians in the US manage their patients with chronic noncancer pain. We conducted Critical Decision Method interviews with ten primary care clinicians about 30 individual patients with chronic pain. In these interviews, we identified several patients, social/environmental, and clinician factors that influence the frames clinicians use to assess their patients and determine a pain management plan. Findings suggest significant ambiguity and uncertainty in clinical pain management decision making. Therefore, interventions to improve pain care might focus on sup- porting sensemaking in the context of clinical evidence rather than attempting to provide clinicians with decontextualized and/or algorithm-based decision rules. Interventions might focus on delivering convenient and easily interpreted patient and social/environmental information in the context of clinical practice guidelines. Keywords Sensemaking · Health · Primary care · Chronic pain · Decision making · Opioids 1 Introduction United States (US), the majority

Journal

"Cognition, Technology & Work"Springer Journals

Published: May 30, 2018

References

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