Physiotherapists' Experiences with and Perspectives on Implementing an Evidence-Based, Chronic Pain Self-Management Programme in Primary Health Care: A Qualitative Study.

Purpose: Evidence suggests that a physiotherapist-led chronic pain self-management programme in primary health care (PHC) improves function for people living with chronic pain; however, implementing a new approach to care can be difficult. In this study, we sought to understand the experiences of ph...

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Published in:Physiotherapy Canada Vol. 73; no. 2; pp. 159 - 168
Main Authors: Brewer, Emily, Carnevale, Nicole, Ducsharm, Melissa, Ellis, Nicole, Khan, Mohammed, Vader, Kyle, Miller, Jordan
Format: research tables/charts Journal Article
Published: University of Toronto Press Spring2021
Online Access:View this record in EBSCOhost
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      dt: Spring2021
      vid: 73
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      pub: University of Toronto Press
      place: North York, Ontario
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        atl: Physiotherapists' Experiences with and Perspectives on Implementing an Evidence-Based, Chronic Pain Self-Management Programme in Primary Health Care: A Qualitative Study.
      aug:
        au:
          Brewer, Emily
          Carnevale, Nicole
          Ducsharm, Melissa
          Ellis, Nicole
          Khan, Mohammed
          Vader, Kyle
          Miller, Jordan
        affil: School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University
      sug:
        subj:
          Chronic Pain Therapy
          Primary Health Care
          Self-Management
          Support, Psychosocial
          Program Implementation
          Physical Therapist Attitudes
          Work Experiences
          Human
          Descriptive Statistics
          Physical Therapy Practice, Evidence-Based
          Qualitative Studies
          Semi-Structured Interview
          Thematic Analysis
          Professional Development
          Culture
          Pain Management
          Purposive Sample
          Professional-Patient Relations
          Data Analysis Software
          Male
          Female
          Ontario
          Male
          Female
      ab:
        Purpose: Evidence suggests that a physiotherapist-led chronic pain self-management programme in primary health care (PHC) improves function for people living with chronic pain; however, implementing a new approach to care can be difficult. In this study, we sought to understand the experiences of physiotherapists who had implemented the ChrOnic pain self-ManageMent support with pain science EducatioN and exerCisE (COMMENCE) programme; its perceived barriers, facilitators, benefits, and drawbacks; and how the physiotherapists tailored the programme to their own clinical contexts. Method: This interpretive description qualitative study used semi-structured interviews with physiotherapists who had implemented the COMMENCE programme in PHC. Results: Themes from 11 interviews included experiences of personal and professional growth, increasing confidence with experience, and changing the culture of pain management. Barriers and drawbacks to implementation included resource intensiveness, balancing programme demands with other clinical work, and challenges with patient attendance and participation. Facilitators included training, programme design and materials, supportive teams, and previous knowledge. Benefits included offering group and individualized support, evidence-based content, and sparking interest in learning more about pain management. The participants made small changes to tailor the programme content and delivery to their context. Conclusions: This study provides a rich understanding of the experiences, barriers, facilitators, benefits, drawbacks, and tailoring related to the COMMENCE programme in PHC. The results will facilitate future implementation of this intervention in PHC settings.
        Objectif : selon les données probantes, un programme d'autogestion de la douleur chronique dirigé par un physiothérapeute en soins primaires améliore la fonction des personnes qui vivent avec la douleur chronique, mais il peut être difficile de mettre en œuvre une nouvelle approche des soins. La présente étude visait à comprendre les expériences des physiothérapeutes qui avaient créé le programme COMMENCE (acronyme anglais pour soutien pour l'autoprise en charge de la douleur chronique par l'éducation et l'exercice de la science de la douleur), les obstacles perçus, les incitations, les avantages et les inconvénients, de même que l'adaptation du programme aux contextes cliniques. Méthodologie : étude qualitative par description interprétative faisant appel à des entrevues semi-structurées auprès de physiothérapeutes qui avaient mis en œuvre le programme COMMENCE en soins primaires. Résultats : les thèmes des 11 entrevues portaient sur les expériences de croissance personnelle et professionnelle, l'augmentation de la confiance grâce à l'expérience et le changement de la culture de gestion de la douleur. Les obstacles ou les écueils de mise en œuvre incluaient l'intensité de ressources nécessaires, l'équilibre entre les exigences du programme et le reste du travail clinique et les difficultés relatives à l'assiduité et à la participation des patients. Les incitations incluaient la formation, la conception et le matériel du programme, les équipes solidaires et les connaissances antérieures. Les avantages incluaient l'offre d'un soutien collectif et individuel, le contenu fondé sur des données probantes et l'intérêt à en apprendre davantage sur la gestion de la douleur. Les participants ont apporté de petits changements pour adapter le contenu et la prestation du programme à leur contexte personnel. Conclusions : la présente étude fournit de riches données sur les expériences, les obstacles, les incitations, les avantages, les écueils et l'adaptation du programme COMMENCE en soins primaires. Les résultats faciliteront la future mise en œuvre de cette intervention en soins primaires.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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