Hartley Cameron, Penlington Chris
Newcastle University, Newcastle, UK.
Br J Pain. 2024 Apr;18(2):120-127. doi: 10.1177/20494637231208095. Epub 2023 Oct 18.
To elicit perspectives of people with persistent pain about their experiences working with pain management professionals and services as patient advocates and to consider implications for current models of involving patients in service development and research.
reflexive thematic analysis from a critical realist perspective.
Online interviews were conducted individually with 10 participants who had acted as patient advocates in the field of persistent pain. Participants were recruited through purposive and snowball sampling. Data were analysed and organised into themes and are presented descriptively.
The relationship between patient advocates and the organisations they help is conceptualised as 'an unequal partnership'. Participants described positive and affirming experiences with individual health professionals and research teams (Respect). This often occurred within a context of inflexible organisational policies that presented barriers to participation including a lack of financial compensation and expectation to work to inflexible deadlines. As a result, patient advocates could experience a lack of value attributed to their experiences and voices (unmet needs from institutions).
People with personal experience of engaging with services for persistent pain are in a strong position to contribute to service improvement. Although this contribution is recognised as valuable, it appears to be devalued by organisational barriers. Organisational policies around payment may lead to a lack of representation of those experiencing higher levels of disadvantage. As a result, services and policy makers may be missing out on insights that could be important for service development.
了解慢性疼痛患者作为患者倡导者与疼痛管理专业人员及服务机构合作的经历,并探讨其对当前患者参与服务发展和研究模式的启示。
基于批判现实主义视角的反思性主题分析。
对10位曾在慢性疼痛领域担任患者倡导者的参与者进行了在线单独访谈。通过目的抽样和滚雪球抽样招募参与者。对数据进行分析并归纳为主题,以描述性方式呈现。
患者倡导者与其所帮助的组织之间的关系被概念化为“不平等的伙伴关系”。参与者描述了与个别医疗专业人员和研究团队的积极且肯定的经历(尊重)。这种情况通常发生在僵化的组织政策背景下,这些政策对参与构成了障碍,包括缺乏经济补偿以及要求在不灵活的期限内工作。结果,患者倡导者可能会觉得自己的经历和声音未得到应有的重视(机构未满足的需求)。
有慢性疼痛服务参与经历的人很有能力为服务改进做出贡献。尽管这种贡献被认为是有价值的,但似乎因组织障碍而被贬低。围绕报酬的组织政策可能导致处于较高不利地位的人群缺乏代表性。因此,服务机构和政策制定者可能会错过对服务发展可能很重要的见解。