Background & Aims
There is a large body of evidence to suggest that effective partnerships between members of the treating Pain Team and patients is key to helping patients begin to lead better and more fulfilling lives (Scascighini, L. Toma, V. Dober-Spielmann, S. & Sprott, H, 2008). Arguably, when working within a united team, pain clinicians know they are not alone, enabling them to stay motivated to provide great care to an extremely challenging group.
The current project provides a description of how an Australian Specialist Pain Service has revised and re-shaped its pain language, work practices, and care practices after conducting an international survey of practice, and creating a new model of persistent pain that is explained and taught to patients. This model was adapted with the aim of providing ‘patient friendly’ descriptions of how persistent pain develops for some people and not others.
The new model, the Pain Avoidance and Meaning Model (PAMM) is an adaptation of Fear Avoidance Model
Methods
An online voluntary self-report survey of clinicians working in existing advertised pain services as listed on the IASP website was sent out in late September of 2019 using Qualtrics software. A total of 180 clinicians responded to the survey, representing many different countries and professions. Clinicians were asked what (if any) model of pain underpinned their assessment and treatment of patients.
The PAMM was developed following the process of an extensive literature review, reflection on the results from the international pain clinician survey and multiple patient and peer group consultations and demonstrations. Variants of the model were discussed during interdisciplinary meetings and patient groups allowing the model to evolve four years. PAMM tools for patients and clinicians have been created to help patients map out their pain experience story and then create a pain restoration plan.
Results
The international pain clinician survey found that the most commonly used pain models being applied by pain clinicians was the Biopsychosocial model (72%), the Fear Avoidance Model (52%) and the Explain Pain model (59%).
The PAMM has now been incorporated into individual and multi-disciplinary pain assessment and treatment, education and group pain management programs running at Monash Health, a large public health organisation in Victoria Australia. Qualitative and quantitative evidence of its effectiveness is building and it has also been used on multiple occasions to educate other clinicians about the development and management of persistent pain.
Conclusions
The PAMM was created to simplify pain science for patients with persistent pain and encourage the use of clear and helpful language by health professionals in healthcare settings. It is now being used in private and public health settings in Australia, New Zealand, and the United States to educate both patients and health professionals about managing persistent pain conditions. Validation studies are currently in progress, and ongoing research is exploring various applications of the PAMM.
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Presenting Author
Sharryn Lydall-Smith
Poster Authors
Sharryn Lydall-Smith
PhD
Monash Health
Lead Author
Justin Moar BPHTY
Precision Brain Pain and Spine
Lead Author
Andrea Funke
B OT (Hons)
Monash Health
Lead Author
Marcus Bowler
BSc(Physio)
Monash Health
Lead Author
David Field
MA Psychology
Metro Pain
Lead Author
Christopher Harris
Lead Author
Topics
- Education