Chronic pain in the paramedic practice setting – a qualitative study of patients’ perspective

Lucinda Peacock, Rachel Lewandowsky, Kelly Ann-Bowles, Bill Lord, Tim Andrews
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Abstract

Chronic pain is highly prevalent among the global population and has a significant impact on a patient's livelihood in multiple areas. Chronic pain is now more widely recognised as a standalone medical condition by most healthcare disciplines, separate from that of acute pain. This has allowed for the development of a unique evidence-based approach to caring for these patients, which incorporates the biological, psychological, and social dimensions in which chronic pain transverses. However, in the paramedic practice setting, chronic pain has received scant mention. This knowledge gap leaves many paramedics operating without guidelines suitable for the care of chronic pain patients or an epidemiological foundation describing the incidence or treatment requirements of this patient cohort. Most importantly, the perspectives and experiences of chronic pain patients who are treated by paramedics have yet to be investigated which is vital to ensure relevant care. To describe and understand the experience of patients requiring ambulance attendance for chronic pain-related complaints. Six participants were enlisted using convenience sampling. Participants responded, via Zoom, to an inductive, semi-structured interview. Analysis was performed using qualitative reflexive thematic analysis with a non-positivist, constructive approach. The themes identified were ‘the impact of stigma’ and ‘inadequate paramedic education’. Most participants shared similar attitudes and experiences regarding paramedic management, expressing dissatisfaction with the current standard of practice in relation to chronic pain complaints. Patients experiencing chronic pain are underserved by the standard of care being offered in this practice setting. Concerns raised by patients centred around the impact both stigma and educational understanding have on treatment. These findings indicate a need for further research, including the revision of guidelines and consideration of the patient perspective to be conducted in this area.
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辅助医务人员实践环境中的慢性疼痛--对患者观点的定性研究
慢性疼痛在全球人口中发病率很高,在多个领域对患者的生活产生重大影响。目前,大多数医疗保健学科都将慢性疼痛视为一种独立的医学症状,与急性疼痛区分开来。这使得护理这些患者的独特循证方法得以发展,其中包含了慢性疼痛所涉及的生物、心理和社会层面。然而,在辅助医务人员的实践环境中,慢性疼痛却鲜有提及。这一知识空白使得许多辅助医务人员在工作中既没有适合慢性疼痛患者的护理指南,也没有描述这一患者群体发病率或治疗要求的流行病学基础。最重要的是,医护人员尚未对接受治疗的慢性疼痛患者的观点和经历进行调查,而这对于确保相关护理至关重要。描述并了解因慢性疼痛相关主诉而需要救护车救治的患者的经历。我们采用便利取样法招募了六名参与者。参与者通过 Zoom 对归纳式、半结构化访谈做出回应。分析采用定性反思性主题分析法和非实证主义的建设性方法进行。确定的主题是 "成见的影响 "和 "辅助医务人员教育不足"。大多数参与者都对辅助医务人员的管理抱有类似的态度和经历,对当前有关慢性疼痛投诉的实践标准表示不满。在这种实践环境下,慢性疼痛患者得不到应有的护理。患者提出的担忧主要集中在耻辱感和教育理解对治疗的影响上。这些研究结果表明,有必要在这一领域开展进一步的研究,包括修订指南和考虑患者的观点。
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1.30
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