56. The ‘myth’ of patient centrality in chronic back pain services (44)

Michelle Howarth, Lecturer, School of Nursing, University of Salford, Salford, United Kingdom
Co author: Carol Haigh
M.L.Howarth2@salford.ac.uk

Abstract:

Background:

The socio-economic effects of chronic back pain are immense. Pain is innate and demands holistic multi-professional care management approaches. To address these demands, the management of chronic back pain should engage a variety of interventions and therapies. Multi-professional working is energetically promoted as a key component (RCA 2003). The complex needs of patients who suffer from chronic back pain suggest that the patient should sit at the heart of decision making in multi-professional services. There is therefore a need to ensure ‘patient centrality’ within service provision (Howarth & Haigh 2007).

Review Aims:

To critically examine the extent of patient centrality within multi-professional chronic back pain management services.

Search Methods:

An iterative search strategy was undertaken in 2006 to locate published research from a range of sites and aggregators between the years 1960 - 2006. Papers were critically appraised for their relevance validity and the quality of the methodological approach.

Findings:

Despite policy rhetoric and guidelines which promote ‘patient centrality’ within multidisciplinary services, evaluations of these services are negligible. Contemporary research has focussed on the assessment of pain as opposed to the patients’ experience of multi-professional services.

Discussion:

The dearth in evidence using the patients’ perspective to evaluate multi-professional working in chronic back pain service is compounded a failure to accurately determine the patient’s pain experience. This may deter effective treatments and exacerbate the patients’ pain symptoms.

Conclusion:

The successful management pain is perhaps the ultimate goal for any pain management service; without further research, patient centrality may indeed be a utopian dream. Evaluation which takes account of the patients’ thoughts about such services could potentially support the development of services which support the reality rather than endorse the rhetoric. This presentation will draw on key findings which outline whether & how patients inform and contribute to multi-professional working.

Biography:

Michelle Howarth (RGN, MSc, PGCHE) Michelle’s professional background as an RGN provided over 10 years of experience which influenced her research career. Michelle has since pursued her research career and has experience in qualitative methodology. Michelle’s PhD is focussed on determining the patient experience of multi-professional working in chronic back pain services and the extent of patient centrality. Carol Haigh From a clinical background in orthopaedic trauma, Carol moved into post registration education in 1989. She developed and ran an MSc in Pain management before moving to her present role as Senior Lecturer in Research in the Salford Centre for Nursing Midwifery and Collaborative Research at The University of Salford. Her PhD centred around osteoporosis and her other research interests include pain management, applications of chaos theory and organisation of care.