دورية أكاديمية
Factors Influencing the Application of a Biopsychosocial Perspective in Clinical Judgement of Chronic Pain: Interactive Management with Medical Students.
| العنوان: | Factors Influencing the Application of a Biopsychosocial Perspective in Clinical Judgement of Chronic Pain: Interactive Management with Medical Students. |
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| المؤلفون: | Dwyer CP; Centre for Pain Research, National University of Ireland, Galway, Ireland; School of Psychology, National University of Ireland, Galway, Ireland., McKenna-Plumley PE; Centre for Pain Research, National University of Ireland, Galway, Ireland., Durand H; Centre for Pain Research, National University of Ireland, Galway, Ireland; School of Psychology, National University of Ireland, Galway, Ireland., Gormley EM; Centre for Pain Research, National University of Ireland, Galway, Ireland., Slattery BW; Centre for Pain Research, National University of Ireland, Galway, Ireland; School of Psychology, National University of Ireland, Galway, Ireland., Harney OM; School of Psychology, National University of Ireland, Galway, Ireland., MacNeela P; School of Psychology, National University of Ireland, Galway, Ireland., McGuire BE; Centre for Pain Research, National University of Ireland, Galway, Ireland; School of Psychology, National University of Ireland, Galway, Ireland. |
| المصدر: | Pain physician [Pain Physician] 2017 Sep; Vol. 20 (6), pp. E951-E960. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society of Interventional Pain Physicians Country of Publication: United States NLM ID: 100954394 Publication Model: Print Cited Medium: Internet ISSN: 2150-1149 (Electronic) Linking ISSN: 15333159 NLM ISO Abbreviation: Pain Physician Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Paducah, Ky. : American Society of Interventional Pain Physicians Original Publication: Paducah, Ky. : Association of Pain Management Anesthesiologists |
| مواضيع طبية MeSH: | Attitude of Health Personnel* , Education, Medical* , Health Knowledge, Attitudes, Practice* , Physician-Patient Relations* , Students, Medical*, Chronic Pain/*therapy , Clinical Decision-Making/*methods , Pain Management/*methods, Adult ; Chronic Pain/diagnosis ; Chronic Pain/psychology ; Female ; Humans ; Male ; Young Adult |
| مستخلص: | Background: Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients. Thus, it is evident that a greater understanding of clinical judgement-making processes and the factors that affect application of these processes is required, particularly regarding chronic pain. Objectives: The aims of the current study were to investigate medical students' conceptualizations of the factors that influence application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain using interactive management (IM), model the relationships among these factors, and make recommendations to chronic pain treatment policy in light of the findings. Study Design: The current study used IM to identify and model factors that influence the application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain, based on medical students' conceptualizations of these factors. Setting: Two university classrooms. Methods: IM is a systems thinking and action mapping strategy used to aid groups in developing outcomes regarding complex issues, through integrating contributions from individuals with diverse views, backgrounds, and perspectives. IM commonly utilizes the nominal group technique and interpretive structural modeling, which in this context were employed to help medical students identify, clarify, and model influences on the application of biopsychosocial perspectives in treating chronic pain patients. Results: Results of IM group work revealed 7 core biopsychosocial approach application categories: GP attitudes, cost, GP knowledge, time, patient-doctor relationship, biomedical factors. and patient perception. GP attitudes was the most critical driver of all other competencies in the system, with cost and GP knowledge revealed as secondary drivers. Limitations: Potential differences in level of prior biopsychosocial perspective knowledge across participants and a potentially small sample size (though consistent with past research and appropriate for an exploratory study of this nature - for purposes of achieving the depth and richness of the deliberation and qualitative insights revealed by participants using the IM methodology). Conclusions: Results from this study may be used to both recommend further research on the identified factors influencing application of biopsychosocial perspectives in treatment of chronic pain and support amendment to extant health care policy, particularly with respect to cost, GP attitudes, and knowledge. Though this research claims neither that the influences identified are the only influences on biopsychosocial application, nor the order of their importance, the research does contribute to an on-going effort to better understand the factors that influence doctors in their treatment of chronic pain.Key words: Chronic pain, biopsychosocial, medical education, clinical judgement, interactive management, pain management. |
| تواريخ الأحداث: | Date Created: 20170922 Date Completed: 20180608 Latest Revision: 20220410 |
| رمز التحديث: | 20221213 |
| PMID: | 28934799 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2150-1149 |
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