RESUMEN
Purpose: Despite being one of the most common medical complaints, chronic pain is difficult to manage due to ineffective communication between providers and patients and time restraints during appointments. Patient-centered questionnaires have the potential to optimize communication by assessing a patient's pain history, prior treatments, and associated comorbidities to develop an effective treatment plan. This study aimed to analyze the feasibility and acceptability of a pre-visit clinical questionnaire aimed at improving communication and pain care. Patients and Methods: The "Pain Profile" questionnaire was piloted across two specialty pain clinics in a large academic medical center. Patient and provider surveys were conducted with patients who completed the Pain Profile questionnaire and providers who use it in practice. Surveys consisted of multiple-choice and open-ended questions regarding the helpfulness, usability, and implementation of the questionnaire. Descriptive analyses of patient and provider surveys were conducted. Qualitative data were analyzed using matrix framework-based coding. Results: A total of 171 patients and 32 clinical providers completed the feasibility and acceptability surveys. 77% of patients (N= 131) found the Pain Profile helpful in communicating their pain experiences and 69% of providers (N= 22) found it helpful in guiding clinical decisions. The section that assessed the impact of pain was rated most helpful by patients (4/5) while the open-ended section asking patients to describe their pain history was rated least helpful by patients and providers (3.7/5 and 4.1/5, respectively). Both patients and providers provided suggestions to future iterations of the Pain Profile, including the addition of opioid risk and mental health screening tools. Conclusion: The Pain Profile questionnaire was feasible and acceptable in a pilot study at a large academic site. Future testing in a large-scale, fully powered trial is needed to assess the effectiveness of the Pain Profile in optimizing communication and pain management.
RESUMEN
Despite the integral role that frontline health care workers play in providing care to older adults and those with chronic conditions and disabilities, few studies have examined the relationships between the working conditions endured by this workforce, the quality of the care they deliver, and the outcomes of patients for whom they care. Thus, the authors: (1) developed a novel conceptual framework that highlights these relationships and (2) performed a comprehensive search and analysis of the literature (PubMed, AgeLine, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, Scopus, Web of Science) to assess the relationships proposed in the framework. A total of 31 studies were included. The results suggest that working conditions affect workers themselves, the care they deliver, and their patients' outcomes. Additional studies, as well as policy solutions, are needed to address the issues faced by this workforce in order to improve health care delivery.
