Karleen F Giannitrapani1,2, Marie C Haverfield1,2, Natalie K Lo1, Matthew D McCaa1, Christine Timko1,2, Steven K Dobscha3,4, Robert D Kerns5,6, Karl A Lorenz1,2,6. 1. VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California. 2. Stanford University, Palo Alto, California. 3. VA Portland Healthcare System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, Oregon. 4. Department of Psychiatry, Oregon Health and Science University, Portland, Oregon. 5. VA Connecticut Healthcare System, Pain Research, Informatics, Multimorbidities and Education (PRIME) Center of Innovation, West Haven, Connecticut. 6. Department of Psychiatry, Neurology and Psychology, Yale School of Medicine, New Haven, Connecticut.
Abstract
OBJECTIVE: Screening for pain in routine care is one of the efforts that the Veterans Health Administration has adopted in its national pain management strategy. We aimed to understand patients' perspectives and preferences about the experience of being screened for pain in primary care. DESIGN: Semistructured interviews captured patient perceptions and preferences of pain screening, assessment, and management. SUBJECTS: We completed interviews with 36 patients: 29 males and seven females ranging in age from 28 to 94 years from three geographically distinct VA health care systems. METHODS: We evaluated transcripts using constant comparison and identified emergent themes. RESULTS: Theme 1: Pain screening can "determine the tone of the examination"; Theme 2: Screening can initiate communication about pain; Theme 3: Screening can facilitate patient recall and reflection; Theme 4: Screening for pain may help identify under-reported psychological pain, mental distress, and suicidality; Theme 5: Patient recommendations about how to improve screening for pain. CONCLUSION: Our results indicate that patients perceive meaningful, positive impacts of routine pain screening that as yet have not been considered in the literature. Specifically, screening for pain may help capture mental health concerns that may otherwise not emerge. Published by Oxford University Press on behalf of the American Academy of Pain Medicine 2020. This work is written by US Government employees and is in the public domain in the US.
OBJECTIVE: Screening for pain in routine care is one of the efforts that the Veterans Health Administration has adopted in its national pain management strategy. We aimed to understand patients' perspectives and preferences about the experience of being screened for pain in primary care. DESIGN: Semistructured interviews captured patient perceptions and preferences of pain screening, assessment, and management. SUBJECTS: We completed interviews with 36 patients: 29 males and seven females ranging in age from 28 to 94 years from three geographically distinct VA health care systems. METHODS: We evaluated transcripts using constant comparison and identified emergent themes. RESULTS: Theme 1: Pain screening can "determine the tone of the examination"; Theme 2: Screening can initiate communication about pain; Theme 3: Screening can facilitate patient recall and reflection; Theme 4: Screening for pain may help identify under-reported psychological pain, mental distress, and suicidality; Theme 5: Patient recommendations about how to improve screening for pain. CONCLUSION: Our results indicate that patients perceive meaningful, positive impacts of routine pain screening that as yet have not been considered in the literature. Specifically, screening for pain may help capture mental health concerns that may otherwise not emerge. Published by Oxford University Press on behalf of the American Academy of Pain Medicine 2020. This work is written by US Government employees and is in the public domain in the US.
Authors: Claire E O'Hanlon; Karleen F Giannitrapani; Charlotta Lindvall; Raziel C Gamboa; Mark Canning; Steven M Asch; Melissa M Garrido; Anne M Walling; Karl A Lorenz Journal: J Gen Intern Med Date: 2021-08-17 Impact factor: 6.473