A Mixed-Methods Investigation into Patients' Decisions to Attend an Emergency Department for Chronic Pain.

Analgesics, Opioid Australia Chronic Pain / therapy Emergency Service, Hospital Health Services Accessibility Humans
Andersen Model Chronic Pain Culturally and Linguistically Diverse Emergency Department Ethnoculture Mixed-Methods

Journal

Pain medicine (Malden, Mass.)
ISSN: 1526-4637
Titre abrégé: Pain Med
Pays: England
ID NLM: 100894201

Informations de publication

Date de publication:
08 10 2021
Historique:
pubmed: 20 3 2021
medline: 22 3 2022
entrez: 19 3 2021
Statut: ppublish

Résumé

This study explored factors that underpin decisions to seek emergency department (ED) care for chronic noncancer pain in patients identifying as culturally and linguistically diverse (CALD) or Australian born. This mixed-methods study was underpinned by the Behavioral Model of Health Services Use conceptual framework. Consenting consecutive patients attending the ED for a chronic pain condition were recruited to a CALD (n = 45) or Australian-born (n = 45) cohort. Statistical comparisons compared the demographic, pain, health literacy, and episode of care profiles of both cohorts. Twenty-three CALD and 16 Australian-born participants consented to an audio-recorded semi-structured interview (n = 24) or focus group (n = 5 focus groups) conducted in their preferred language. Interviews were translated and transcribed into English for analysis using applied thematic analysis, guided by the conceptual framework. Data were triangulated to investigate the patterns of ED utilization and contributing factors for both cohorts. ED attendance was a product of escalating distress, influenced by the degree to which participants' perceived needs outweighed their capacity to manage their pain. This interaction was amplified by the presence of predisposing factors, including constrained social positions, trauma exposure, and biomedical health beliefs. Importantly, experiences varied between the two cohorts with higher degrees of pain catastrophizing, lower health literacy, and greater social challenges present for the CALD cohort. This study highlights the role contextual factors play in amplifying pain-related distress for CALD and Australian-born patients with chronic pain. The findings support a need for health care providers to recognize features of higher vulnerability and consider streamlining access to available support services.

Identifiants

DOI: 10.1093/pm/pnab081 PMID: 33739379 PMC: PMC8500722
pubmed: 33739379
pii: 6178804
doi: 10.1093/pm/pnab081
pmc: PMC8500722
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2191-2206

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Bernadette Brady (B)

School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
Liverpool Hospital, Liverpool, NSW, Australia.
Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
ORCID: 0000-0002-2611-6736

Toni Andary (T)

Fairfield Hospital, Fairfield, NSW, Australia.

Sheng Min Pang (SM)

Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.

Sarah Dennis (S)

Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.

Pranee Liamputtong (P)

School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
Translational Health Research Institute, Western Sydney University, NSW, Australia.

Robert Boland (R)

Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Fairfield Hospital, Fairfield, NSW, Australia.

Elise Tcharkhedian (E)

Liverpool Hospital, Liverpool, NSW, Australia.

Matthew Jennings (M)

School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
Liverpool Hospital, Liverpool, NSW, Australia.

Natalie Pavlovic (N)

Fairfield Hospital, Fairfield, NSW, Australia.

Marguerite Zind (M)

School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.

Paul Middleton (P)

Liverpool Hospital, Liverpool, NSW, Australia.
South Western Emergency Research Institute (SWERI), The Ingham Institute, Liverpool, Australia.
South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
Discipline of Emergency Medicine, University of Sydney, Sydney, Australia.
The MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia.

Lucy Chipchase (L)

School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
College of Nursing and Health Sciences, Flinders University, South Australia, Australia.

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