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Ruskin D, Szczech K, Tyrrell J, Isaac L. Innovative Program to Prevent Pediatric Chronic Postsurgical Pain: Patient Partner Feedback on Intervention Development. Healthcare (Basel) 2024; 12:360. [PMID: 38338245 PMCID: PMC10855720 DOI: 10.3390/healthcare12030360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The risk of developing chronic postsurgical pain (CPSP) in youth is related to psychological factors, including preoperative anxiety, depression, patient/caregiver pain catastrophizing, and poor self-efficacy in managing pain. While interventions exist to address these factors, they are generally brief and educational in nature. The current paper details patient partner feedback on the development of a psychologist-delivered perioperative psychological program (PPP) designed to identify and target psychological risk factors for CPSP and improve self-efficacy in managing pain. METHODS Qualitative interviews were conducted with two patients and their caregivers to discuss their surgical and pain management experience and to advise on components of the PPP. RESULTS Reflexive thematic analysis of interviews generated the following themes, which were incorporated into the content and implementation of the PPP: caregiver involvement, psychological and physical strategies for pain management, biopsychosocial pain education, intervention structure, and supporting materials. CONCLUSIONS The development of a novel psychologist-led PPP is a promising approach to mitigate mental health risks associated with pediatric CPSP and potentially boost postoperative outcomes and family wellbeing. Integrating patient partner feedback ensures that the PPP is relevant, acceptable, and aligned with the needs and preferences of the patients it is designed to serve.
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Affiliation(s)
- Danielle Ruskin
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (J.T.); (L.I.)
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
| | - Klaudia Szczech
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
| | - Jennifer Tyrrell
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (J.T.); (L.I.)
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Lisa Isaac
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (J.T.); (L.I.)
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Ruskin D, Borsatto J, Szczech K, Tremblay M, D’Alessandro LN, Mesaroli G, Sun N, Munns C, Stinson J. "Working Together": Perspectives of Healthcare Professionals in Providing Virtual Care to Youth with Chronic Pain during the COVID-19 Pandemic. Int J Environ Res Public Health 2023; 20:4757. [PMID: 36981665 PMCID: PMC10048812 DOI: 10.3390/ijerph20064757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The onset of the coronavirus disease in 2019 necessitated a rapid transition to virtual care for chronic pain treatment. METHODS A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Interviews were conducted in February 2021 with a sample of healthcare professionals (HCPs; n = 6) who had provided multidisciplinary treatment (MDT) through an outpatient hospital pediatric chronic pain program. Satisfaction surveys were distributed to all MDT professionals employed by the clinic in April 2021 (n = 13 of 20 eligible; 65% response rate). Participants represented medicine, rehabilitation, and mental health professionals. RESULTS Analysis of interviews generated five themes: (1) adaptation to virtual care, (2) benefits of virtual care, (3) limitations of virtual care, (4) shifting stance on virtual care over time, and (5) considerations for implementing virtual care. The satisfaction survey data revealed that respondents were able to effectively provide appropriate diagnoses, recommendations, and/or care plans for pediatric chronic pain via virtual care (n = 12, 92.3%). Detailed survey responses are presented by discipline. CONCLUSIONS This study provides a rich exploration of HCPs' experiences in providing MDT for pediatric chronic pain within a virtual care model. The current results may contribute to the future development of guidelines for virtual care delivery with pediatric chronic pain populations.
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Affiliation(s)
- Danielle Ruskin
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
| | - Julia Borsatto
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Klaudia Szczech
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Monique Tremblay
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Lisa N. D’Alessandro
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Giulia Mesaroli
- Department of Rehabilitation Services, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Naiyi Sun
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Catherine Munns
- Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Jennifer Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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Ruskin D, Tremblay M, Szczech K, Rosenbloom BN, Mesaroli G, Sun N, D'Alessandro LN. Virtual multidisciplinary pain treatment: Experiences and feedback from children with chronic pain and their caregivers. Physiother Theory Pract 2023:1-21. [PMID: 36748713 DOI: 10.1080/09593985.2023.2171750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The onset of the coronavirus disease 2019 (COVID-19) necessitated a rapid transition to virtual care for chronic pain treatment. OBJECTIVE This study examined experiences of patients and caregivers who received virtual multidisciplinary pain treatment (MDT) for pediatric chronic pain between March 2020 and August 2021. METHODS A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Satisfaction surveys were administered to a convenience sample of patients (aged 8 to 18; N = 20) and their caregivers (N = 20) who received MDT through an outpatient hospital pediatric chronic pain program. Interviews were conducted with a subset of these patients and their caregivers (n = 6). RESULTS Analysis of interviews revealed four themes: 1) benefits of virtual care; 2) challenges of virtual care; 3) recommendations and evaluation of virtual care; and 4) patient preferences. Analysis of the satisfaction survey data revealed that while patients and caregivers were satisfied with many aspects of virtual care, 65% (n = 13) of patients reported a preference for in-person appointments, with caregivers showing equal preference for in-person and virtual appointments, though this was a non-significant difference (p = .37). Overall, both patients and caregivers stated a stronger preference for in-person physiotherapy sessions but were willing to have psychology sessions provided virtually. Finally, the most reported preference was for a hybrid model of care incorporating at least some in-person contact with providers. CONCLUSION This study provides a rich exploration of virtual care for multidisciplinary pediatric chronic pain treatment. The current results may inform the future development of guidelines for virtual care delivery with pediatric chronic pain populations.
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Affiliation(s)
- Danielle Ruskin
- Department of Psychology, Hospital for Sick Children, Toronto, ON Canada
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON Canada
- Department of Psychology, York University, Toronto, ON Canada
| | - Monique Tremblay
- Department of Psychology, Hospital for Sick Children, Toronto, ON Canada
| | - Klaudia Szczech
- Department of Psychology, Hospital for Sick Children, Toronto, ON Canada
| | - Brittany N Rosenbloom
- Department of Psychology, Hospital for Sick Children, Toronto, ON Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Giulia Mesaroli
- Department of Rehabilitation Services, Hospital for Sick Children, Toronto, ON Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON Canada
| | - Naiyi Sun
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON Canada
| | - Lisa N D'Alessandro
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
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