Chronic pain care

Abstract

Objective Experiencing pain not only affects patients' biopsychosocial functioning but also the existential domain. Attention to the existential, in addition to the biopsychosocial domains, might thus be important in chronic pain care. Therefore, we investigated: (a) how satisfied patients were with the attention of their practitioners to the impact of pain on biological, psychological, social, and existential life domains, and (b) how satisfaction with each domain was related to patient functioning. Method Pain patients ( N = 163) were questioned on their satisfaction with the attention of their practitioners to biological, psychological, social, and existential life domains, and on pain intensity, pain disability, life satisfaction, and depressive symptoms. Results Patients reported low satisfaction with the attention of their practitioners to the social and existential domains. Satisfaction with each domain was negatively related with pain intensity, pain disability, and depressive symptoms and positively related with life satisfaction. Only satisfaction with the existential domain was able to predict all functional outcomes above and beyond all other satisfaction variables modeled simultaneously. Conclusions Patients reported not feeling satisfied with the attention to the social and existential life domains. Furthermore, practitioners' attention to the existential domain seems highly important for patient functioning. Openness to existential concerns of pain patients might thus be an important aspect of chronic pain care.

Doctor–patient communication about existential, spiritual and religious needs in chronic pain: A systematic review

“…We found one article with quantitative design (see Table 1) (Dezutter et al, 2016), one employing a mixed methods design (Zander et al, 2015) and two using a qualitative approach (Bullington, Nordemar, Nordemar, & Sjostrom-Flanagan, 2003;Carson, Katz, & Alegría, 2016). The quantitative study was from Belgium (Dezutter et al, 2016), analysing patients' experiences of the doctor-patient communication and their satisfaction with the attention given to the impact of pain on their meaning in life by the treatment teams or medical doctors. Patients' satisfaction with the attention was measured using a 4-point Likert-type scale ranging from 1 (very dissatisfied) to 4 (very satisfied) and further related to patient functioning indicated by, for example, depressive symptoms, pain intensity and disability.…”

‘Maybe we are losing sight of the human dimension’ – physicians’ approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study

“…Suffering, illness, and confrontation with death can trigger an existential crisis that evokes a diversity of different existential needs (Cullberg, 1993;Frankl, 1982;Larsen, Hall, Spiritual carea type of healthcare encompassing attention to patients' existential, spiritual, and religious needsis already included in the World Health Organization's (WHO) recommendations for terminal and palliative patients. However, there are no guidelines for delivering spiritual care to patients suffering from chronic diseases, although they also experience existential, spiritual, and religious needs as evidenced in specific studies (Büssing et al, 2009;Dezutter et al, 2016) and in Koenig and colleagues' comprehensive review of different illnesses' inter-relationship to existential, spiritual, and religious themes (Koenig et al, 2012).…”

Clients’ Faith Experiences as an Opportunity or a Challenge for Psychotherapy: A Qualitative Analysis of Clinical Records

“…However, the bio-psycho-social model still lacked dimensions of importance for the patient. Therefore, a growing body of researchers recommended including an existential, or spiritual, dimension as well (Sulmasy 2002;Dezutter et al 2016;Koenig et al 2012;Pargament 2007;APA 2013;Dyer 2011). In this article, faith is defined as the client's belief in anything transcendent to which he or she can adhere to (Moestrup and Hvidt 2016) and covers the practice of both spirituality and religiosity.…”

“…Although research has shown that faith is a legitimate human expression that influences health, healthcare personnel seemed reluctant to approach these needs (Dezutter et al 2016;Assing Hvidt et al 2016;Andersen et al 2019). This may have been due to a lack of knowledge and/or training, as well as an apprehension regarding imposing their own meaning system on the patients Mueller et al 2001;Best et al 2016).…”