Patients' perspectives and experiences about private practice health care management of their chronic musculoskeletal pain

[摘要] ENGLISH SUMMARY : Background: Understanding patients' perspectives about living with chronic pain in the South African context and their views about the private health care they received is important because it can identify facilitators and barriers for health care management. It was proposed that this information would produce meaningful information to be incorporated into the health care management of chronic musculoskeletal pain (CMSP) patients.Aim: The purpose of this study was to explore patients' perspectives about living with CMSP and their experiences with health care management of their CMSP in the private health care sector of South Africa.Methodology: A descriptive qualitative case study design with an interpretative and phenomenological approach was conducted. The sampling was purposive. Fourteen patients with CMSP were recruited to participate in semi-structured individual interviews. The research was conducted in the private health care sector of the West Coast region of the Western Cape, South Africa. The interviews were recorded and transcribed ensuring confidentiality. Inductive, thematic content analysis of the transcripts was undertaken. Initial codes were assigned and a codebook was developed, which was applied to the transcripts to develop categories and themes.Results: Eight themes emerged from the data: (1) living with chronic pain, (2) disrupted identity, (3) knowledge and beliefs about chronic pain, (4) health care system factors, (5) interactions with health care providers, (6) management of CMSP, (7) hope (or hopelessness) for the future, and (8) barriers and facilitators to pain management in this context.Conclusions: Participants with CMSP indicated that there were numerous challenges throughout their journey with chronic pain in the private health care sector of South Africa. Participants had a disjointed pathway of care and management of HCP did not offer the solutions that the participants were hoping for, which led to depersonalised care. This study supports the need for establishing a way of collaboration and communication to achieve multidisciplinary care to benefit the CMSP patients in the West Coast region. Two options are the formation of a multidisciplinary pain clinic or pain academy or group in the region. Case managers might also be an option to assist patients to navigate through the HCS. Patients require pain education, self-management strategies and emotional support throughout the process of coming to terms with their chronic pain and redefining their self-identity. Empowering patients with self-management strategies enhance coping mechanisms needed for chronic pain and to regain a sense of control over their lives. In the end this could lead to participants' being able to accept and manage their future with pain.

[发布机构] Stellenbosch University