Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study
Objectives This study explored cancer pain management practices and clinical care pathways used by healthcare professionals (HCPs) to understand the barriers and facilitators for standardised pain management in oncology outpatient services (OS).Design Data were collected using semistructured intervi...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e078619.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849722964292927488 |
|---|---|
| author | Kate Flemming Adam Hurlow Elaine Boland Simon Pini Marie Fallon Daniel Swinson Suzanne H Richards Catriona R Mayland Matthew R Mulvey Natasha Campling Olivia C Robinson Sue Hartup |
| author_facet | Kate Flemming Adam Hurlow Elaine Boland Simon Pini Marie Fallon Daniel Swinson Suzanne H Richards Catriona R Mayland Matthew R Mulvey Natasha Campling Olivia C Robinson Sue Hartup |
| author_sort | Kate Flemming |
| collection | DOAJ |
| description | Objectives This study explored cancer pain management practices and clinical care pathways used by healthcare professionals (HCPs) to understand the barriers and facilitators for standardised pain management in oncology outpatient services (OS).Design Data were collected using semistructured interviews that were audio-recorded and transcribed. The data were analysed using thematic analysis.Setting Three NHS trusts with oncology OS in Northern England.Participants Twenty HCPs with varied roles (eg, oncologist and nurse) and experiences (eg, registrar and consultant) from different cancer site clinics (eg, breast and lung). Data were analysed using thematic analysis.Results HCPs discussed cancer pain management practices during consultation and supporting continuity of care beyond consultation. Key findings included : (1) HCPs’ level of clinical experience influenced pain assessments; (2) remote consulting impeded experienced HCPs to do detailed pain assessments; (3) diffusion of HCP responsibility to manage cancer pain; (4) nurses facilitated pain management support with patients and (5) continuity of care for pain management was constrained by the integration of multidisciplinary teams.Conclusions These data demonstrate HCP cancer pain management practices varied and were unstructured. Recommendations are made for a standardised cancer pain management intervention: (1) detailed evaluation of pain with a tailored self-management strategy; (2) implementation of a structured pain assessment that supports remote consultations, (3) pain assessment tool that can support both experienced and less experienced clinicians. These findings will inform the development of a cancer pain management tool to integrate within routine oncology OS. |
| format | Article |
| id | doaj-art-e513ffc0a2da4da48fd3f66839ee9cb1 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e513ffc0a2da4da48fd3f66839ee9cb12025-08-20T03:11:10ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-078619Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative studyKate Flemming0Adam Hurlow1Elaine Boland2Simon Pini3Marie Fallon4Daniel Swinson5Suzanne H Richards6Catriona R Mayland7Matthew R Mulvey8Natasha Campling9Olivia C Robinson10Sue Hartup11Department of Health Sciences, Faculty of Science, The University of York, York, UKPalliative Care Team, Leeds Teaching Hospitals NHS Trust, Leeds, UKPalliative Medicine, Hull University Teaching Hospitals NHS Trust, Hull, UKPsychological and Social Medicine, University of Leeds, Leeds, UKMRC Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UKLeeds Cancer Centre, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK9 Leeds Institute of Health Sciences, University of Leeds, Leeds, UKDepartment of Oncology and Metabolism, The University of Sheffield, Sheffield, UKLeeds Institute of Health Sciences, University of Leeds, Leeds, UKSchool of Health Sciences, University of Southampton, Southampton, Hampshire, UKLeeds Institute of Health Sciences, University of Leeds, Leeds, UKSt. James`s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UKObjectives This study explored cancer pain management practices and clinical care pathways used by healthcare professionals (HCPs) to understand the barriers and facilitators for standardised pain management in oncology outpatient services (OS).Design Data were collected using semistructured interviews that were audio-recorded and transcribed. The data were analysed using thematic analysis.Setting Three NHS trusts with oncology OS in Northern England.Participants Twenty HCPs with varied roles (eg, oncologist and nurse) and experiences (eg, registrar and consultant) from different cancer site clinics (eg, breast and lung). Data were analysed using thematic analysis.Results HCPs discussed cancer pain management practices during consultation and supporting continuity of care beyond consultation. Key findings included : (1) HCPs’ level of clinical experience influenced pain assessments; (2) remote consulting impeded experienced HCPs to do detailed pain assessments; (3) diffusion of HCP responsibility to manage cancer pain; (4) nurses facilitated pain management support with patients and (5) continuity of care for pain management was constrained by the integration of multidisciplinary teams.Conclusions These data demonstrate HCP cancer pain management practices varied and were unstructured. Recommendations are made for a standardised cancer pain management intervention: (1) detailed evaluation of pain with a tailored self-management strategy; (2) implementation of a structured pain assessment that supports remote consultations, (3) pain assessment tool that can support both experienced and less experienced clinicians. These findings will inform the development of a cancer pain management tool to integrate within routine oncology OS.https://bmjopen.bmj.com/content/13/12/e078619.full |
| spellingShingle | Kate Flemming Adam Hurlow Elaine Boland Simon Pini Marie Fallon Daniel Swinson Suzanne H Richards Catriona R Mayland Matthew R Mulvey Natasha Campling Olivia C Robinson Sue Hartup Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study BMJ Open |
| title | Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study |
| title_full | Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study |
| title_fullStr | Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study |
| title_full_unstemmed | Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study |
| title_short | Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study |
| title_sort | exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals a qualitative study |
| url | https://bmjopen.bmj.com/content/13/12/e078619.full |
| work_keys_str_mv | AT kateflemming explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT adamhurlow explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT elaineboland explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT simonpini explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT mariefallon explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT danielswinson explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT suzannehrichards explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT catrionarmayland explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT matthewrmulvey explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT natashacampling explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT oliviacrobinson explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy AT suehartup explorationofpainassessmentandmanagementprocessesinoncologyoutpatientserviceswithhealthcareprofessionalsaqualitativestudy |