‘I think there is nothing . . . that is really comprehensive’: healthcare professionals’ views on recommending online resources for pain self-management
Restricted accessResearch articleFirst published online November, 2021
‘I think there is nothing . . . that is really comprehensive’: healthcare professionals’ views on recommending online resources for pain self-management
To explore healthcare professionals’ views on, and attitudes, towards recommending online resources for persistent pain self-management.
Methods:
This study was the qualitative phase of a two-phase mixed method study. Thirty-one New Zealand health professionals involved in the management of persistent pain were interviewed via focus groups and individual interviews. Data were analysed using the general inductive approach.
Results:
The major themes were as follows: (1) risks and limits of online information outweigh benefits, (2) a blended model, of online resources with healthcare professional support, could work, (3) only trustworthy resources can be recommended, (4) need for personalisation and (5) perceived barriers to adoption.
Conclusion:
Online resources were perceived as a useful adjunct to support pain self-management; however, due to potential risks of misinterpretation and misinformation, healthcare professionals proposed a ‘blended model’ where curated online resources introduced during face-to-face consultations could be used to support self-management. Participants needed ‘trustworthy online resources’ that provide evidence-based, updated information that is personalised to clients’ health literacy and cultural beliefs.
Practice implications:
Training for healthcare professionals on critical appraisal of online resources or curation of evidence-based online resources could increase recommendation of online resources to support pain self-management as an adjunct to in-person care.
Annual Update of Key Results. 2018/19: New Zealand health survey, 2019, https://bit.ly/39NbyjA
2.
VosTAllenCAroraM, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet2016; 388(10053): 1545–1602.
3.
TreedeR-DRiefWBarkeA, et al. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the: international classification of diseases:(ICD-11). Pain2019; 160(1): 19–27.
LorigKRHolmanHR.Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med2003; 26(1): 1–7.
6.
ClauwDJEssexMNPitmanV, et al. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med2019; 131(3): 185–198.
7.
NijsJGirbésELLundbergM, et al. Exercise therapy for chronic musculoskeletal pain: innovation by altering pain memories. Man Ther2015; 20(1): 216–220.
8.
MoseleyGLButlerDS.Fifteen years of explaining pain: the past, present, and future. J Pain2015; 16(9): 807–813.
9.
McCrackenLMVowlesKE.Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol2014; 69(2): 178–187.
10.
GotinkRAChuPBusschbachJJ, et al. Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PLoS ONE2015; 10(4): e0124344.
11.
WilliamsAEcclestonCMorleyS.Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev2012; 11(11): CD007407.
12.
GatchelRJMcGearyDDMcGearyCA, et al. Interdisciplinary chronic pain management: past, present, and future. Am Psychol2014; 69(2): 119–130.
13.
FosterNEAnemaJRCherkinD, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet2018; 391(10137): 2368–2383.
14.
HoggMNGibsonSHelouA, et al. Waiting in pain: a systematic investigation into the provision of persistent pain services in Australia. Med J Aust2012; 196(6): 386–390.
15.
KontosEBlakeKDChouWY, et al. Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012. J Med Internet Res2014; 16(7): e172.
16.
DevanHPerryMAvan HattemA, et al. Do pain management websites foster self-management support for people with persistent pain? A scoping review. Patient Educ Couns2019; 102(9): 1590–1601.
17.
VoVAuroyLSarradon-EckA.Patients’ perceptions of mHealth apps: meta-ethnographic review of qualitative studies. JMIR Mhealth Uhealth2019; 7(7): e13817.
18.
MerolliMGrayKMartin-SanchezF.Therapeutic affordances of social media: emergent themes from a global online survey of people with chronic pain. J Med Internet Res2014; 16(12): e284.
19.
BondCSMerolliMAhmedOH.Chapter 2 – patient empowerment through social media. In: Syed-abdulSGabarronELauAYS (eds) Participatory Health through Social Media. Cambridge: Academic Press, 2016, pp.10–26.
20.
BhattaraiPNewton-JohnTPhillipsJL.Apps for older people’s pain self-management: perspectives of primary care and allied health clinicians. Pain Med2019; 21: 686–694
21.
DevanHGodfreyHKPerryMA, et al. Current practices of health care providers in recommending online resources for chronic pain self-management. J Pain Res2019; 12: 2457–2472.
22.
MorganDL.The focus group guidebook. Thousand Oaks, VA: SAGE, 1998.
23.
KeglerMCRaskindIGComeauDL, et al. Study design and use of inquiry frameworks in qualitative research published in Health Education & Behavior. Health Educ Behav2019; 46(1): 24–31.
MorganDL.Reconsidering the role of interaction in analyzing and reporting focus groups. Qual Health Res2010; 20(5): 718–722.
26.
TongASainsburyPCraigJ.Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care2007; 19(6): 349–357.
27.
SinclairCHollowayKRileyG, et al. Online mental health resources in rural Australia: clinician perceptions of acceptability. J Med Internet Res2013; 15(9): e193.
28.
WhitfieldGWilliamsC.If the evidence is so good–why doesn’t anyone use them? A national survey of the use of computerized cognitive behaviour therapy. Behav Cogn Psychother2004; 32(01): 57–65.
29.
ThomasDR.A general inductive approach for analyzing qualitative evaluation data. Am J Eval2006; 27(2): 237–246.
30.
MadillAJordanAShirleyC.Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies. Br J Psychol2000; 91(Pt. 1): 1–20.
31.
FettersMDCurryLACreswellJW.Achieving integration in mixed methods designs – principles and practices. Health Serv Res2013; 48(6Pt.2): 2134–2156.
32.
BarrettAKajamaaAJohnstonJ. How to . . . be reflexive when conducting qualitative research. Clin Teach2020; 17(1): 9–12.
33.
RamaniSKöningsKDMannK, et al. A guide to reflexivity for qualitative researchers in education. Acad Med2018; 93(8): 1257–1257.
34.
GubaEG.Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ1981; 29(2): 75–91.
35.
BenetoliAChenTAslaniP.How patients’ use of social media impacts their interactions with healthcare professionals. Patient Educ Couns2018; 101(3): 439–444.
36.
VeehofMTrompetterHBohlmeijerE, et al. Acceptance-and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cogn Behav Ther2016; 45(1): 5–31.
37.
ManiMKavanaghDJHidesL, et al. Review and evaluation of mindfulness-based iPhone apps. JMIR Mhealth Uhealth2015; 3(3): e82.
38.
BakerKSGeorgiou-KaristianisNGibsonSJ, et al. Optimizing cognitive function in persons with chronic pain. Clin J Pain2017; 33(5): 462–472.
39.
DwarswaardJBakkerEJvan StaaA, et al. Self-management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies. Health Expect2016; 19(2): 194–208.
40.
DevanHHaleLHempelD, et al. What works and does not work in a self-management intervention for people with chronic pain? Qualitative systematic review and meta-synthesis. Phys Ther2018; 98(5): 381–397.
41.
ParsonsLAdamsJ.The accessibility and usability of an Australian web-based self-management programme for people with lower health literacy and joint pain in the UK: a qualitative interview study. Musculoskeletal Care2018; 16(4): 500–504.
42.
FarnoodAJohnstonBMairFS.A mixed methods systematic review of the effects of patient online self-diagnosing in the ‘smart-phone society’ on the healthcare professional-patient relationship and medical authority. BMC Med Inform Decis Mak2020; 20(1): 1–14.
43.
HeapyAAHigginsDMCervoneD, et al. A systematic review of technology-assisted self-management interventions for chronic pain. Clin J Pain2015; 31(6): 470–492.
44.
SlaterHDearBFMerolliMA, et al. Use of eHealth technologies to enable the implementation of musculoskeletal models of care: evidence and practice. Best Pract Res Clin Rheumatol2016; 30(3): 483–502.
45.
DevanHFarmeryDPeeblesL, et al. Evaluation of self-management support functions in apps for people with persistent pain: systematic review. JMIR MHealth UHealth2019; 7(2): e13080.
46.
ChapmanLBrooksCLawsonJ, et al. Accessibility of online self-management support websites for people with osteoarthritis: a text content analysis. Chronic Illn2019; 15(1): 27–40.
47.
WashingtonTAFanciulloGJSorensenJA, et al. Quality of chronic pain websites. Pain Med2008; 9(8): 994–1000.
48.
SørensenKVan den BrouckeSFullamJ, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health2012; 12(1): 80.
49.
BreivikHCollettBVentafriddaV, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain2006; 10(4): 287–333.
50.
BlythFMMarchLMBrnabicAJ, et al. Chronic pain in Australia: a prevalence study. Pain2001; 89(2–3): 127–134.
51.
DornerTEMuckenhuberJStroneggerWJ, et al. The impact of socio-economic status on pain and the perception of disability due to pain. Eur J Pain2011; 15(1): 103–109.
52.
Díaz AndradeAHedgesMRKarimikiaH, et al. World Internet Project: the Internet in New Zealand 2017. Auckland: New Zealand Work Research Institute, 2018.
53.
LewisGNUpsdellA.Ethnic disparities in attendance at New Zealand’s chronic pain services. NZ Med J2018; 131: 21–28.
54.
BradyBVeljanovaIChipchaseL.An exploration of the experience of pain among culturally diverse migrant communities. Rheumatol Adv Pract2017; 1(1): rkx002.
55.
BradyBVeljanovaIChipchaseL.Are multidisciplinary interventions multicultural? A topical review of the pain literature as it relates to culturally diverse patient groups. Pain2016; 157(2): 321–328.
56.
MhurchuCNTe MorengaLTupai-FirestoneR, et al. A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@): a cluster-randomised controlled trial. Lancet Digital Health2019; 1(6): e298–e307.
57.
HikuroaD.Mātauranga Māori – the ūkaipō of knowledge in New Zealand. J R Soc N Z2017; 47(1): 5–10.
58.
MeadHM.Tikanga Maori (revised edition): Living by Maori values. Wellington: Huia Publishers, 2016.
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