Background & Aims
Postoperative pain is a known consequence of surgery. Even though there are different interventions to reduce pain, too many patients still experience moderate to severe pain after surgery [2]. In current clinical practice, various self-reported tools to assess pain intensity exist [5 ;10], but barriers reduce their usefulness [12-14]. For future efficiency and development of health care, digital solutions and using patient reported data, can provide more effective and personalized care [3; 8]. Digital solutions targeting postoperative pain have promising results [1;11]. However, additional research is warranted to facilitate their integration into clinical practice [1]. As a first step guiding the implementation of digital patient self-reporting pain monitoring [6; 7; 9], we wanted to explore healthcare providers`perspectives on using digital tools in everyday clinical practice. We aimed to explore healthcare providers perceived challenges and benefits related to utilizing digital pain intensity monitoring in different contexts. Second, we aim to use this knowledge to guide the implementation strategy for a digital pain self-report tool.
Methods
We employed a qualitative design with semi-structured focus group interviews of health care providers working with postoperative patients. The interview guide had open-ended questions about the health care practitioners experience with postoperative pain assessment and management, and perspectives on utilizing digital solutions in clinical practice. The interview guide was tested in a pilot and discussed in the research team to ensure that questions asked for had potential to explore the research-question. Seven focus group interviews with a total of 39 healthcare personnel from different hospital-departments (Postoperative/ Intensive care units, General surgery wards and Orthopedic wards) at two hospitals at the west coast of Norway were conducted. The interviews lasted from 57 mins to 80 mins. Transcribed interviews were analyzed according to the six steps of Reflexive thematic analysis [4].
Results
Analyses resulted in two main themes and six sub-themes from the material: (1) Challenges associated with utilizing digital pain intensity monitoring and (2) Perceived benefits utilizing digital pain measures in clinical practice. Sub-themes were (1.1) Pain assessment is contextual and complex, (1.2) Professional assessment overrides subjective reports, (1.3) Variable patient / situational fit of digital self-report, (1.4) Total digital burden, (2.1) Preventing loss of control by mapping, and (2.2) Patient empowerment by enhanced communication.
Conclusions
The results suggest how the complexity of pain necessitates context-dependent assessment and show how healthcare providers worry that digital systems can reduce bedside nursing, underestimating their clinical value. These are important insights to plan implementation. Moreover, there seems to be an understanding that digital pain monitoring can add valuable insights into the patient’s pain. Digital patient reported scoring might empower patient communication and enhance control but will not be useful for all patients in all situations. The intervention must be tailored to the specific setting.
The local data protection officer at District General Hospital of Førde approved the study (eProtocol 3942). The Regional Committees for Medical and Health Research Ethics in the west region of Norway evaluated it not necessary to obtaining permission from the committee (646937), as it is a study of professionals’ perspectives. Head nurse / department manager in included health trusts externally from District General Hospital of Førde, obtained approval from the data protection officer at their own health trust regarding participation in the study. Written informed consent was obtained before the interview and stored in a secure place to preserve anonymity. Secure data storage with separated key area in the Western Norway Regional Health Authority was used for storage of transcribed interviews and audio files.
There is evidence indicating that healthcare providers tend to underestimate patients’ self-reported pain, and that documentation of pain is inadequate. Digital monitoring holds promise in addressing these barriers to effective pain assessment, thereby potentially improving pain management. To effectively tailor interventions to different healthcare settings and meet the needs of organizations and patients, it is crucial to engage relevant stakeholders in the development and implementation of digital solutions. This ensures that future digital tools adequately address the requirements of healthcare professionals and patients alike. The findings of this study underscore the importance of collaborating with end-users and considering department-specific routines and demands in healthcare to effectively meet future needs.
References
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Presenting Author
Cecilie M. Øvrebotten
Poster Authors
Cecilie M. Øvrebotten
MSc (PhD student)
Department of Surgery, District General Hospital of Førde, Førde, Norway
Lead Author
Runar T. Hovland
PhD
Department of Research and Innovation, District General Hospital of Førde, Førde, Norway
Lead Author
Janne Cecilie Låver
MSc (PhD student)
Department of Health and Caring sciences, Western Norway University of Applied Sciences, Førde, Norway
Lead Author
Signe Berit Bentsen
PhD (Professor)
Department of Health and Caring sciences, Western Norway University of Applied Sciences, Førde, Norway
Lead Author
Christian Moltu
PhD (Professor)
Department of Psychiatry, District General Hospital of Førde, Førde, Norway
Lead Author
Topics
- Assessment and Diagnosis