Pain Management and Patients-Centered Care Principles - Essay Example

HOW TO ASSESS AND PLAN PAIN MANAGEMENT ACCORDING TO PATIENTS CENTERED CARE PRINCIPLES Name Course Tutor University Date Introduction In the recent past, patient centred concept has become one of the key aims of health care systems in pain management. Patient centred care refers to the innovative approaches of planning, delivering and evaluating health care of a patient, based on partnerships between patients, their family members and the health care professionals (Newton, Reeves, West & Schofield 2014, p. 140). Increased numbers of patients living with pain are requesting to be involved as partners in the provision of their care (Newton, Reeves, West & Schofield 2014, p. 140). The purpose of patient centred health care is to respect the wants, preferences, needs and values of such patients. The impact of pain to a patient and their families has to be evaluated to come up with effective pain management interventions (Alharbi et al. 2014, p. 105). According to Alharbi et al, (2014, p. 105), pain is viewed as a symptom of other forms of diseases rather than being a condition on its own. Consequently, no standard ways of commissioning pain management services exist, making it seem like a big burden due to its constant use of resources (Barry et al. 2013, p. 1076). The presence of competent ways of helping health care setups to measure and monitor their performance and customer listening capacities systematically is an important factor that contributes to patient centred care. According to Barry et al. (2013, p. 1077), the listening capacity of a health care organization should comprise of diverse performance measurements, such as surveys of patient experiences and assessments of patient complaints and loyalty. This essay discusses the systematic ways of assessing pain management from a patient centred perspective, their importance in planning for pain management interventions and gives recommendations of some of the applicable solutions if management of pain is not successful that match principles of patients centred care. How to assess and plan pain management, according to patient centred care principles Assessing and planning for pain management using the patient centred approach are used to make sure that people living with pain are offered pain management services, which are centred on their needs and the needs of the caregivers. Chronic pain has made a great impact to the society as a whole making it necessary for appropriate management interventions to be made (Barry et al. 2013, p. 1076). A health survey done in England showed that there were fourteen million people diagnosed with chronic pain (pain lasting more than six months), and one out of four people had stopped performing their daily activities due to pain (Collins 2014, p. 1). Collins (2014, p. 1) also reveals that ,while older people were diagnosed with chronic people than younger people, thirty-seven percent of women and thirty-one percent of men complained of chronic pain. Barry & Edgman-Levitan ( 2012, p. 786) states that there are various benefits of patient centred care in management of chronic pain categorized in clinical benefits, operational benefits and care experience. According to Lorig (2012, p. 532), when health care professionals, health care administrators, patients and families work collaboratively, there is an increase in patient and health care provider satisfaction, decrease of costs and increase in the quality of safety of patient and health care. Barry and Edgman-Levitan (2012, p. 786) however, claims that in health care quality improvement programs, one cannot manage what one cannot measure. There have been many strategies aimed at helping people to be more central about pain management and general care and effective assessment methods are needed to gauge the extent to which provision of care is person centred (Barry & Edgman-Levitan, 2012, p. 786). Consequently, health care professionals are able to differentiate worthwhile initiatives from unworthy ones. According to Balasubramanian and Spurgeon (2013, p. 209), the reasons why person centred care is assessed are to gauge the quality of service provided, and to determine if the preferences and needs of a patient are being met. One of the ways of assessing if the needs and preferences of the patients living with pain are being met are gauging their education and information levels about their painful conditions and ways to manage them through interviews (Balasubramanian & Spurgeon 2013, p. 204). According to Dodd (2014, p. 286), people who have low health literacy have poorer health, minimal understanding of their health and higher mortality rates than people who are adequately educated about their health. Patients living with pain can be asked to describe their experiences and information they have about their painful conditions to gauge how much they understand their condition (Balasubramanian & Spurgeon 2013, p. 204). A person centred approach to care giving in pain management involves informing the patient about their conditions and the ways of managing it because they have the right to such knowledge (Balasubramanian & Spurgeon 2013, p. 204). Such information does not only include knowing the condition, but also, how to live with it. The information offers the patient encouragement to participate in peer support and educational programs, and this, in turn, help them to live independently. According to Epstein and Street (2011, p. 101), a recent National Pain Audit suggested that more than fifty percent of patients living with pain did not feel that they got a clear understanding of their condition from pain clinics. Conducting in depth interviews as an assessment method of pain management based on a person centred perspective, gives guidelines on patients' understanding of their conditions (Epstein & Street 2011, p. 102). Such information will inform decision makers on effective interventions in pain management and offer guidelines on improving the patient’s access self-management information, educational programs and peer support groups. There exist various types of surveys that are valid and can be used to assess the aspect of person centred care for management of pain. These surveys include person centred Care Assessment Tool, Individualised Care Scale, Measure of processes of Care Scale and Person-centred Climate Questionnaire (Campinha-Bacote, 2011, p. 234). The Individualised Care Scale is used to measure the ability of a health professional to respond to the individual needs of a patient living with pain. The scale has two versions, one for patients and another for nurses (Campinha-Bacote, 2011, p. 234). Application of the Individualised Care Scale in the United States of America and Europe has proved that it is reliable and valid (Campinha-Bacote, 2011, p. 234). The Measure of Processes of Care tool, on the other hand, is in most cases filled by guardians of children using hospital and rehabilitation services (Campinha-Bacote, 2011, p. 234). Also, a version exists for professionals, and it is used in North America, Australia and South Africa. It has given proof that it gives valid information adequate for forming pain management plans (Epstein & Street, 2011, p. 103). Professionals mostly use Person-centred Care Assessment Tool whose main aim is for self-reporting of nurses (Balogh et al. 2011, p. 1800). Having been used in hospitals and residential homes for the aged mostly in Europe, it has proved to be effective in providing information that can improve person centred care (Balogh et al. 2011, p. 1800). Nurses after self-reporting are able to gauge their performance in providing person centred health care and determine ways of improving their services to people living with pain. Finally, Person-centred Climate Questionnaire has been adopted by various hospitals in Australia and United Kingdom and has been found to be effective in exploring the extent to which provision of health care is person centred (Roumie et al. 2011, p. 244). Due to the rising prevalence of pain and the unpredictability of its chronic nature, there have been various challenges for health care providers to provide adequate management care (Roumie et al. 2011, p. 244). Adoption of the main types of assessment tools of person centred care will inform policy makers, service leaders and service providers of the more effective methods of managing pain. The various types of valid surveys existing will help health care providers determine the approaches of pain management that are not appropriate for management of pain and do not improve the quality of life of patients (Luxford, Safran & Delbanco 2011, p. 510). According to Eipstein et, al. (2010, p. 1490), the most common ways of assessing person centred care to patients living with pain are surveys of clinicians and observation of clinical outcomes. Eipstein et al. (2010, p. 1490) also states that the provision of care to patient living with pain cannot be regarded as a linear or episodic pathway, especially for people who have ongoing care needs, due to long term pain conditions. Different types of assessment can be conducted at varying points during the patients care continuum to help manage his or her pain (Luxford, Safran & Delbanco 2011, p. 510). One of the ways assessment can be done to plan for management of pain is asking clinicians the extent to which they feel that care provided to patients living with pain by their colleagues was person centred (Luxford, Safran & Delbanco 2011, p. 510). The surveys can be conducted in paper form and can be targeted to specific programs. The approach of observing clinicians clinical encounters also offers an effective assessment tool (Roumie et al. 2011, p. 244). The observations made when clinicians are either with real or simulated patients, through recording or in person are very informative. Asking clinicians some hypothetical questions, about what they would do in certain encounters with people living with painful conditions is an effective way of assessing shared decision-making and communication (Roumie et al. 2011, p. 244). Conducting interviews and with people living with pain, who are being provided health care is an effective way of informing pain management plans. Different aspects of person centred care that are assessed are the definitions or the preferences of the patient before provision of care, the experiences during health care provisions, and the experiences and outcomes after the health care encounter. According to Balasubramanian and Spurgeon (2013, p. 209), patients reported that the best assessment method of their care experiences was being questioned on their experiences. Patients' experiences reflect their perception of the health care provided to them, and their satisfaction with the type of care offered (Lorig 2012, p. 534). Collins (2014, p. 1), states that in depth interviews conducted with twenty-nine elderly people admitted to acute hospitals and their family members were effective method of attaining feedback and improving the type of service the patients were receiving because the patients reported of improved person centred care in the management of their conditions. Barry et al. (2013, 1077), also gives the positivity of conducting semi-structured interviews with seventeen people who had chronic back pain during a one year period and their perceptions about person centred care. Interviews where patients are encouraged to describe their preferences, needs and the care being offered are useful to them in improving person centred care to people living with pain. Focusing on feedback from patients using state and territorial surveys is one of the most effective methods of assessing patient centred care. According to Barry et al. (2013, 1077), in Australia and United Kingdom, the most commonly used methods of assessing the experiences of patients to determine the extent to which care was patient centred is surveys, done across different health settings. The results of the surveys conducted in various areas or health facilities are used to monitor performance of health care professionals in providing person centred health care, identify trends, compare results of provision of person-centred health care with similar service providers and set level of care standards (Alharbi et al. 2014, p. 105). The results of the surveys are also used to inform policy makers and health service providers on the initiatives for planning for management of pain, patient safety and quality health care. Population based surveys about the health care are also conducted, being focused on private households, to collect population based feedback concerning health care experiences at a national level. Multipurpose Household Survey serves as a good example of a population based survey that focuses on some of the key health care issues such as general practice, dentistry, inpatient and emergency, specialists and pathology (Epstein & Street 2011, p. 102). Population based surveys aimed at gathering information about provision of person centred health care are advantageous because they focus on gathering information on the effectiveness of person centred health care. In addition, Population based surveys determine the number of people who did not access person centred health care and the underlying reasons (Epstein & Street 2011, p. 102). Balasubramanian and Spurgeon (2013, p. 207) states that after reviewing clinical incidents in King Edward Memorial Hospital, it was discovered that there was a deficiency of quality monitoring processes, follow up and assessments of pain management initiatives and partnership in person centred care because patients and family members were not involved (Balasubramanian & Spurgeon 2013, p. 204). Furthermore, Balogh et al. (2011, p. 1800) discovered that during care planning, patients were not adequately involved and health care professional did not offer them a basis for informed consent. Such information is important in improving the provision of quality person centred health care and management of pain by informing policy and decision makers of some initiatives to implement. For example, it can be used to advance the health care professionals’ understanding of person centred health care and how to practice it by providing job training, education packaging and technical assistance. Information from surveys on the provision of health centred health care can also be used to develop policy statements and offer guidelines to health care decision makers and program planners (Balogh et al. 2011, p. 1800). Conclusion After assessments and evaluations of pain management efforts by health care providers, it is clear that some do not satisfy the patients nor do they reduce the pain. Interviews and surveys are the main methods of assessing pain management using a person centred approach. The patient living with pain is the only one who can explain his experience of health services offered to him (Epstein & Street 2011, p. 102). When commissioning services, therefore, it is important that the patient be at the centre, in order to understand the issues he is facing. When the patient is not satisfied with the kind of care given to them or pain management interventions do not work, it is wise for health care professionals to make individual evaluations to determine the barriers. To increase the value of quality pain management, patients should be seen by the right health care provider, at the right time (Balasubramanian & Spurgeon 2013, p. 204). The patient also has to be involved in the person centred management planning process, the right approach of management used and patient focused health outcomes targeted. There should also be proper access of services in all locations. All biosocial needs of the patient need to be met, and therefore, a wide range of specifically trained people should offer their services to ensure proper management of pain. The services of management of pain using a person centred approach are ever changing, and therefore, health care professional should be competent enough to provide the right services at the right time (Balasubramanian & Spurgeon 2013, p. 204). References Alharbi, TSJ, Olsson, LE, Ekman, I & Carlström, E 2014, ‘The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care,’ Scandinavian journal of public health, 42(1), pp. 104-110. Balasubramanian, S & Spurgeon, P 2013, ‘Integrated care for chronic pain management in the National Health Service: barriers and possibilities for service development–a survey,’ The International Journal of Clinical Leadership, 17(4), pp. 201-210. Balogh, EP, Ganz, PA, Murphy, SB, Nass, SJ, Ferrell, BR & Stovall, E 2011, ‘Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop,’ The oncologist, 16(12), pp. 1800-1805. 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