Paper Info
Title
Understanding how primary care clinicians make sense of chronic pain.
Abstract
Chronic pain leads to reduced quality of life for patients, and strains health systems worldwide. In the US and some other countries, the complexities of caring for chronic pain are exacerbated by individual and public health risks associated with commonly used opioid analgesics. To help understand and improve pain care, this article uses the data frame theory of sensemaking to explore how primary care clinicians in the US manage their patients with chronic noncancer pain. We conducted Critical Decision Method interviews with ten primary care clinicians about 30 individual patients with chronic pain. In these interviews, we identified several patients, social/environmental, and clinician factors that influence the frames clinicians use to assess their patients and determine a pain management plan. Findings suggest significant ambiguity and uncertainty in clinical pain management decision making. Therefore, interventions to improve pain care might focus on supporting sensemaking in the context of clinical evidence rather than attempting to provide clinicians with decontextualized and/or algorithm-based decision rules. Interventions might focus on delivering convenient and easily interpreted patient and social/environmental information in the context of clinical practice guidelines.
Year
DOI
Venue
2018
10.1007/s10111-018-0491-1
Cognition, Technology & Work
Keywords
Field
DocType
Sensemaking,Health,Primary care,Chronic pain,Decision making,Opioids
Decision rule,Public health,Chronic pain,Psychological intervention,Quality of life,Sensemaking,Knowledge management,Intensive care medicine,Primary care,Decision model,Engineering
Journal
Volume
Issue
ISSN
20
4
1435-5558
Citations 
PageRank 
References 
1
0.36
7
Authors
7
Name
Order
Citations
PageRank
Laura G. Militello15611.11
Shilo Anders28812.76
Sarah M Downs311.04
Julie DiIulio411.71
Elizabeth C. Danielson510.36
Robert W. Hurley651.83
Christopher A. Harle7248.84