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Challenges and visions for managing pain-related insomnia in primary care using the hybrid CBT approach: a small-scale qualitative interview study with GPs, nurses, and practice managers.
- Source :
- BMC Family Practice; 10/20/2021, Vol. 22 Issue 1, p1-13, 13p
- Publication Year :
- 2021
-
Abstract
- Background: Chronic pain and insomnia have a complex, bidirectional relationship – addressing sleep complaints alongside pain may be key to alleviating patient-reported distress and disability. Healthcare professionals have consistently reported wanting to offer psychologically informed chronic pain management at the primary care level. Research in secondary care has demonstrated good treatment efficacy of hybrid CBT for chronic pain and insomnia. However, primary care is typically the main point of treatment entry, hence may be better situated to offer treatments using a multidisciplinary approach. In this study, primary care service providers' perception of feasibility for tackling pain-related insomnia in primary care was explored. Methods: The data corpus originates from a feasibility trial exploring hybrid CBT for chronic pain and insomnia delivered in primary care. This formed three in-depth group interviews with primary care staff (n = 9) from different primary care centres from the same NHS locale. All interviews were conducted on-site using a semi-structured approach. Verbal data was recorded, transcribed verbatim and analysed using the thematic analysis process. Results: Eight themes were identified – 1) Discrepant conceptualisations of the chronic pain-insomnia relationship and clinical application, 2) Mismatch between patients' needs and available treatment offerings, 3) Awareness of psychological complexities, 4) Identified treatment gap for pain-related insomnia, 5) Lack of funding and existing infrastructure for new service development, 6) General shortage of psychological services for complex health conditions, 7) Multidisciplinary team provision with pain specialist input, and 8) Accessibility through primary care. These mapped onto four domains - Current understanding and practice, Perceived facilitators, Perceived barriers, Ideal scenarios for a new treatment service – which reflected the focus of our investigation. Taken together these provide key context for understanding challenges faced by health care professionals in considering and developing a new clinical service. Conclusions: Primary care service providers from one locale advocate better, multidisciplinary treatment provision for chronic pain and insomnia. Findings suggest that situating this in primary care could be a feasible option, but this requires systemic support and specialist input as well as definitive trials for success. [ABSTRACT FROM AUTHOR]
- Subjects :
- INSOMNIA treatment
CHRONIC pain treatment
CHRONIC pain
HEALTH services administrators
NURSES' attitudes
HEALTH services accessibility
HEALTH facility administration
ATTITUDE (Psychology)
RESEARCH methodology
PHYSICIANS' attitudes
MEDICAL personnel
INTERVIEWING
LABOR demand
PRIMARY health care
QUALITATIVE research
HEALTH care teams
THEMATIC analysis
ENDOWMENTS
COGNITIVE therapy
PAIN management
PSYCHIATRIC treatment
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 14712296
- Volume :
- 22
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Family Practice
- Publication Type :
- Academic Journal
- Accession number :
- 153122915
- Full Text :
- https://doi.org/10.1186/s12875-021-01552-3