Patient Experiences Navigating Chronic Pain Management in an Integrated Health Care System: A Qualitative Investigation of Women and Men.
Pain Med
; 19(suppl_1): S19-S29, 2018 09 01.
Article
em En
| MEDLINE
| ID: mdl-30203009
ABSTRACT
Background:
Rates of pain among veterans are as high as 60%; rates approach 80% in women seeking Department of Veterans Affairs (VA) care. Prior studies examined experiences managing pain in community samples, with gender disparities observed. As the largest national integrated health care system in the country, the VA offers a unique environment to a) study perceptions of pain care among men and women and b) contrast experiences using an integrated health care setting with prior observations in the private sector.Methods:
A purposive sample of chronic pain patients was recruited to qualitatively describe perceptions of managing pain in an integrated health care system (VA) and to explore gender differences. A constant comparative approach with sequential analysis was used to reach thematic consensus.Results:
Ten focus groups (N = 48; six groups of women [N = 22]; four groups of men [N = 26]) revealed an overarching theme, "just keep plugging," which reflected pain as a constant struggle. Three subthemes emerged "always a reacquaintance process" described frustration with the use of trainees in the medical center. The need to navigate "so many hoops" referred to frustrations with logistical barriers. "To medicate or not" reflected tensions around medication use. A distinct theme, "the challenges of being female," reflected women's perceptions of stigma and bias.Conclusions:
Most of the identified challenges were not unique to the integrated setting. Findings revealed advantages to receiving pain care in this setting. Tensions between patient expectations and guidelines governing provider behavior emerged. Improved patient education, provider communication and sensitivity to the unique needs of women may optimize care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
United States Department of Veterans Affairs
/
Prestação Integrada de Cuidados de Saúde
/
Pesquisa Qualitativa
/
Dor Crônica
/
Manejo da Dor
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Pain Med
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article