Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec 21;7(12):e018411.
doi: 10.1136/bmjopen-2017-018411.

Meta-ethnography to understand healthcare professionals' experience of treating adults with chronic non-malignant pain

Francine Toye  1 , Kate Seers  2 , Karen L Barker  3
Affiliations

Meta-ethnography to understand healthcare professionals' experience of treating adults with chronic non-malignant pain

Francine Toye et al. BMJ Open. .

Abstract

Objectives: We aimed to explore healthcare professionals' experience of treating chronic non-malignant pain by conducting a qualitative evidence synthesis. Understanding this experience from the perspective of healthcare professionals will contribute to improvements in the provision of care.

Design: Qualitative evidence synthesis using meta-ethnography. We searched five electronic bibliographic databases from inception to November 2016. We included studies that explore healthcare professionals' experience of treating adults with chronic non-malignant pain. We used the GRADE-CERQual framework to rate confidence in review findings.

Results: We screened the 954 abstracts and 184 full texts and included 77 published studies reporting the experiences of over 1551 international healthcare professionals including doctors, nurses and other health professionals. We abstracted six themes: (1) a sceptical cultural lens, (2) navigating juxtaposed models of medicine, (3) navigating the geography between patient and clinician, (4) challenge of dual advocacy, (5) personal costs and (6) the craft of pain management. We rated confidence in review findings as moderate to high.

Conclusions: This is the first qualitative evidence synthesis of healthcare professionals' experiences of treating people with chronic non-malignant pain. We have presented a model that we developed to help healthcare professionals to understand, think about and modify their experiences of treating patients with chronic pain. Our findings highlight scepticism about chronic pain that might explain why patients feel they are not believed. Findings also indicate a dualism in the biopsychosocial model and the complexity of navigating therapeutic relationships. Our model may be transferable to other patient groups or situations.

Keywords: healthcare professionals; meta-ethnography; pain management; qualitative evidence synthesis; qualitative research.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of records identified and studies removed and included.
Figure 2
Figure 2
Line of argument.
See this image and copyright information in PMC

References

    1. IASP. Classification of chronic pain. Seattle, USA: International Association for the Study of Pain (IASP) Press, 1994.
    1. Fayaz A, Croft P, Langford RM, et al. . Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016;6:e010364 10.1136/bmjopen-2015-010364 - DOI - PMC - PubMed
    1. Donaldson L. 2009 Annual Report of the Chief Medical Office (Department of Health. 2009. http://www.sthc.co.uk/Documents/CMO_Report_2009.pdf (accessed 11 Sep 12).
    1. Breivik H, Collett B, Ventafridda V, et al. . Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006;10:287–333. 10.1016/j.ejpain.2005.06.009 - DOI - PubMed
    1. Nahin RL. Estimates of pain prevalence and severity in adults: United States. J Pain 2015;16:769–80. 10.1016/j.jpain.2015.05.002 - DOI - PMC - PubMed

Publication types

LinkOut - more resources