The current practice of social work in pain management: a scoping review on chronic disease

Experiences of cross-sectoral collaboration between social security service and healthcare service for patients with chronic pain - a qualitative study

OBJECTIVES

Patients with chronic pain need healthcare services for pain management. Many also require social security services due to potential negative influence of chronic pain on social and work-related issues. The aim of this study was therefore to investigate the experiences of taking part in cross-sectoral collaborative meetings between social security service and healthcare service for chronic pain patients.

METHODS

A qualitative study using semi-structured individual interviews with 15 informants, including healthcare providers, patients, and social security supervisors who had taken part in 8 different meetings, was conducted. The focus of the interviews was how the informants experienced cross-sectoral collaborative meetings. The data were analyzed following the systematic text condensation method, including the steps of total impression, identifying meaning units, condensation, and synthesizing.

RESULTS

The findings were categorized into four themes: "Joining the meeting with preconceptions," which showed how some informants experienced that negative preconceptions toward the social security service were addressed in the cross-sectoral collaborative meetings and solved in some cases. "Get to know each other," which highlighted that the meetings provided opportunities for participants to increase their knowledge about the involved actors. "Access to detailed health information?" indicated that although concerns about whether sensitive health information should be shared with social security supervisors were raised by healthcare providers, the supervisors found this issue to be less concerning. Finally, "Who has the final word?", which showed that unclarity over decision-making processes during the meetings was experienced to create disagreement between participants.

CONCLUSIONS

The informants experienced that cross-sectoral collaborative meetings between patients, social security supervisors, and healthcare providers, while challenging, can play a significant role in managing the needs of patients with chronic pain. The study highlights the need for clarification over the roles of the actors and a jointly agreed-upon agenda for the meetings to ensure effective collaboration.

Waiting in Pain II: An Updated Analysis of the Multidisciplinary Staffing Levels and Clinical Activity in Australian Specialist Persistent Pain Services

This study provides an update on multidisciplinary staffing and clinical activity in Australian specialist persistent pain services. Of the 109 services identified, 57 responded, met inclusion criteria and completed a study-specific questionnaire detailing service characteristics, staff resources, and clinical activities. Where possible, data were compared between the 'Waiting in Pain' (WIP) investigations (WIP-I: Dec'08-Jan'10, WIP-II: Jul'16-Feb'18). WIP-II found more pain services (Level 1 centres, rural services) and more full-time equivalent (FTE) staffing (overall, psychiatry, psychology, occupational therapy) than WIP-I. Although Level 1 centres employed more FTE staff (overall, medical) than Level 2 clinics, staffing was comparable when considered relative to clinical activity and this was stable over time for most disciplines. Clinical activity in metropolitan and rural services also remained stable, as did rural service staffing (type, FTE), suggesting that newer clinics replicated existing models. WIP-II highlighted greater diversity in group structures than WIP-I and an associated mean .02FTE allied health staff/patient seen (WIP-I = .03 FTE). Staffing (amounts, types) did not change significantly over time when considered relative to clinical activity, supporting the conclusion that these are workable clinical structures. However, changes in group format (duration, staffing) suggest a shift towards lower-intensity programmes that require less allied health staffing to deliver. PERSPECTIVE: This article presents updated data regarding multidisciplinary staffing profiles, clinical activity, and group programme structures within Australian specialist persistent pain services and examines changes since the original investigation. As the only published staffing profile for multidisciplinary pain services, this project provides critical information to inform service (re)design and care delivery.

Reliability, construct validity, and factorial structure of a Swedish version of the medical outcomes study social support survey (MOS-SSS) in patients with chronic pain

OBJECTIVES

This study aimed to examine the psychometric properties of a Swedish version of the Medical Outcomes Study Social Support Survey (MOS-SSS).

METHODS

Standard forward-backward translation was used. A cross-sectional survey was conducted among treatment seeking individuals with chronic pain included in a clinical cohort. Internal consistency was measured with Cronbach's α, test-retest reliability was examined with intraclass correlation, confirmatory factor analyses was used for examining factor structure, and correlations between the MOS-SSS and selected health validity measures were used for testing concurrent validity hypotheses.

RESULTS

182 participants were included in the study. Internal consistency measured with Cronbach's alpha was acceptable for all subscales and for the total support index of the MOS-SSS. Test-retest reliability was moderate - good for the different subscales, and was good for the overall support index. The original four factor model of the MOS-SSS was confirmed, and the concurrent validity hypotheses were also confirmed; however, the associations were weaker than expected.

CONCLUSIONS

The Swedish version of the MOS-SSS was found psychometrically sound and offers a systematic assessment of social support in specialized pain care.