Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium.
Nursing Department, Ghent University Hospital, Ghent, Flanders, Belgium.
PLoS One. 2022 Aug 25;17(8):e0273576. doi: 10.1371/journal.pone.0273576. eCollection 2022.
The prevention and treatment of chronic pain problems in breast cancer follow-up care require an adequate response from healthcare providers. Generally, this involves the uptake of evidence-based principles regarding pain management in everyday practice. However, despite the extensive literature on effective pain interventions, systematic and coordinated follow-up care is lacking for breast cancer survivors with pain problems in Flanders, Belgium.
This study aimed to gather insight into healthcare providers' perceptions of pain prevention and treatment in breast cancer follow-up care, particularly with attention to the multilevel influences on pain follow-up.
We conducted four online focus groups with twenty-two healthcare providers from different disciplines such as oncologists, pharmacists, nurses, physiotherapists, and psychologists. Data analysis was guided by the Qualitative Analysis Guide of Leuven. This guide is inspired by the constant comparison method, based on Grounded Theory.
The identified influencing factors were thematically grouped into four levels: at the level of the individual healthcare provider, in interaction with the patient, in interaction with colleagues, and at the context level. At each level, we distinguished factors related to healthcare providers' perceptions such as awareness, knowledge, attitudes, beliefs, experiences, and intentions. For example, because of a lack of knowledge and certain beliefs among healthcare providers, referral to other disciplines often does not happen in the context of pain.
This study points out the need to explore the prevention and treatment of chronic pain after breast cancer from a multidimensional point of view. This involves not only the characteristics of individual healthcare providers but is also inherently interactional and system-like in nature. This analysis provides opportunities for the development of interventions that target the influencing factors of prevention and treatment of chronic pain in breast cancer survivors.
乳腺癌随访中慢性疼痛问题的预防和治疗需要医疗保健提供者做出充分的反应。通常，这涉及在日常实践中采用基于证据的疼痛管理原则。然而，尽管有大量关于有效疼痛干预的文献，但比利时佛兰德斯的乳腺癌幸存者的疼痛问题仍缺乏系统和协调的随访护理。
本研究旨在了解医疗保健提供者对乳腺癌随访中疼痛预防和治疗的看法，特别是关注对疼痛随访具有多层面影响的因素。
我们对来自不同学科的 22 名医疗保健提供者（包括肿瘤学家、药剂师、护士、物理治疗师和心理学家）进行了四次在线焦点小组讨论。数据分析由鲁汶定性分析指南指导。该指南的灵感来自于基于扎根理论的不断比较方法。
确定的影响因素在主题上分为四个层次：个体医疗保健提供者层面、与患者相互作用层面、与同事相互作用层面和背景层面。在每个层面上，我们都区分了与医疗保健提供者的看法相关的因素，例如意识、知识、态度、信念、经验和意图。例如，由于医疗保健提供者缺乏知识和某些信念，在疼痛背景下，他们通常不会向其他学科转介。
本研究指出，需要从多维角度探讨乳腺癌后慢性疼痛的预防和治疗。这不仅涉及个体医疗保健提供者的特点，而且本质上是相互作用和系统的。这种分析为针对乳腺癌幸存者慢性疼痛预防和治疗的影响因素开发干预措施提供了机会。
