Trust and Distrust in Opioid Decision-Making: A Qualitative Assessment of Patient-Doctor Relationship

Cho, Hoyune E.; Billig, Jessica I.; Byrnes, Mary E.; Haase, Steven C.; Waljee, Jennifer F; Chung, Kevin C.

doi:10.1016/j.jhsa.2021.10.013

Cited by 8 publications

(20 citation statements)

References 36 publications

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“…Accordingly, they believed the prescribers when they said that the patient had already been given enough opioids 44 . As a result, they were taking all their prescribed opioids without considering whether they needed pain treatment, or they were doing what they believed their surgeon wanted them to do 46,48 …”

Section: Resultsmentioning

confidence: 99%

“…They emphasised the importance of including patients’ preferences in their pain management approach instead of having a homogenous approach 18 . They wished to comprehend the justification for prescribing opioids through honest discussion, regardless of whether the surgeon prescribed them or not 46 . Patient outcomes were enhanced by patient engagement and explanations of the pain management approach.…”

Section: Resultsmentioning

confidence: 99%

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Experiences and perspectives of adults on using opioids for pain management in the postoperative period

Aljohani,

Almalki,

Dixon

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Opioids play an important role in peri-operative pain management. However, opioid use is challenging for healthcare practitioners and patients because of concerns related to opioid crises, addiction and side effects. OBJECTIVE This review aimed to identify and synthesise the existing evidence related to adults’ experiences of opioid use in postoperative pain management. DESIGN Systematic scoping review of qualitative studies. Inductive content analysis and the Theoretical Domains Framework (TDF) were applied to analyse and report the findings and to identify unexplored gaps in the literature. DATA SOURCES Ovid MEDLINE, PsycInfo, Embase, CINAHL (EBSCO), Cochrane Library and Google Scholar. ELIGIBILITY CRITERIA All qualitative and mixed-method studies, in English, that not only used a qualitative approach that explored adults’ opinions or concerns about opioids and/or opioid reduction, and adults’ experience related to opioid use for postoperative pain control, including satisfaction, but also aspects of overall quality of a person's life (physical, mental and social well being). RESULTS Ten studies were included; nine were qualitative (n = 9) and one used mixed methods. The studies were primarily conducted in Europe and North America. Concerns about opioid dependence, adverse effects, stigmatisation, gender roles, trust and shared decision-making between clinicians and patients appeared repeatedly throughout the studies. The TDF analysis showed that many peri-operative factors formed people's perceptions and experiences of opioids, driven by the following eight domains: Knowledge, Emotion, Beliefs about consequences, Beliefs about capabilities, Self-confidence, Environmental Context and Resources, Social influences and Decision Processes/Goals. Adults have diverse pain management goals, which can be categorised as proactive and positive goals, such as individualised pain management care, as well as avoidance goals, aimed at sidestepping issues such as addiction and opioid-related side effects. CONCLUSION It is desirable to understand the complexity of adults’ experiences of pain management especially with opioid use and to support adults in achieving their pain management goals by implementing an individualised approach, effective communication and patient–clinician relationships. However, there is a dearth of studies that examine patients’ experiences of postoperative opioid use and their involvement in opioid usage decision-making. A summary is provided regarding adults’ experiences of peri-operative opioid use, which may inform future researchers, healthcare providers and guideline development by considering these factors when improving patient care and experiences.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Experiences and perspectives of adults on using opioids for pain management in the postoperative period

Aljohani,

Almalki,

Dixon

et al. 2024

European Journal of Anaesthesiology

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“…In studies conducted with surgical patients it was stated that improved/effective communication increases patients' trust in the surgical team and comfort of care (Craig-Schapiro et al, 2018; Hogikyan et al, 2021), the quality of surgeon-patient interaction and communication is an indicator of the quality of care and the basis of surgical care (Jannu&Jahagirdar, 2021) and surgeons have strong beliefs that they will act in the interests of themselves and the medical institution (Cho et al, 2022). In another study, some surgical patients stated that lack of honesty and paternalistic approach negatively affected trust in the surgeon (Hogikyan et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Allowing the patients to make decisions for themselves in an informed, trusting environment is an approach that increases the patients' cooperation in the treatment process and also supports their autonomy (Fritz&Holton, 2019; Gabay&Bokek-Cohen, 2019). In the study conducted with patients in the surgical clinic, participants stated that physicians had authority due to their specialized knowledge and experience, that physicians treated many patients similar to themselves, and that they believed that the prescribed treatment plan was right for them (Cho et al, 2022). Reducing pain and ensuring symptom control during the treatment process are factors that increase trust in the physician.…”

Section: Relationship Between Scale Sub-dimension and Total Pointmentioning

confidence: 99%

Surgical Patients’ Views on Physicians’ Communication Skills in Building Trust: A Cross-sectional Descriptive Study

Aslan,

Işık,

Özdemir

et al. 2024

Preprint

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The objective of the study is to determine the hospitalized surgical patients’ opinions about the communication skills of the physicians in building trust and the factors affecting them. 201 patients staying at the surgical unit constituted the sample of study. The data collection form consisted of demographic data and the Scale of Trust Communication in the Patient-Physician Relationship. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Bonferroni correction and Spearman correlation coefficient have been used to analyze the data. The Scale of Trust Communication in the Patient-Physician Relationship total point average was 86.15 ± 10.34. A meaningful relationship was found between the total score and trust in the physician health care attitude, trust in the physician decisions and the patient’s behavior regarding the payment status. The trust communication average score of the patients was high, and the total scale point average increased as the sub-scale averages increased.

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“…In hospital departments the tendency of doctors is to ignore and avoid these conflicts [7], which actually impedes their effective communication and affects rapport. While prior studies have confirmed that employing good strategies improves patients' compliance [8] and enhances their relationship [9], the rapport between doctors and patients is still an untapped research area in pragmatics and conversation analysis. With limited communication skills, doctors commonly feel overwhelmed to construct a good relationship with patients in out-patient clinics.…”

Section: Introductionmentioning

confidence: 99%

Weaving rapport: doctors’ strategies towards patients’ noncompliance

Tian

Zhang

Haiyang

et al. 2023

BMC Health Serv Res

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Background A successful therapeutic rapport between doctors and patients is built on effective doctor-patient communication. Noncompliance of patients which challenges their communication has been described in the research, yet the rapport strategies are not well discussed. Methods This qualitative study investigates the rapport strategies when doctors face noncompliance in consultations and its pragmatic effects achieved through the doctors’ speeches. The 10-hour recordings come from the doctor-patient communication in the hospital setting. Thereafter, we analyze their conversation following the Spencer Oatey’s rapport management model. Results Compliments and joking in the illocutionary domain, storytelling in the discourse domain, the doctors’ participation in the participation domain and the choice of appropriate titles in the stylistic domain are identified and analyzed as the rapport-building strategies. Conclusion The present study has offered insights into physicians’ rapport-building strategies in the face of rapport-threatening behavior from patients. These strategies will help the doctors to deal with rapport-challenging behavior and boost overall patient wellness.

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Trust and Distrust in Opioid Decision-Making: A Qualitative Assessment of Patient-Doctor Relationship

Cited by 8 publications

References 36 publications

Experiences and perspectives of adults on using opioids for pain management in the postoperative period

Experiences and perspectives of adults on using opioids for pain management in the postoperative period

Surgical Patients’ Views on Physicians’ Communication Skills in Building Trust: A Cross-sectional Descriptive Study

Weaving rapport: doctors’ strategies towards patients’ noncompliance

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