___________________________________________________ Pain Assessment and Management, 2nd Edition
the experience of pain is individual; it is important for prac- titioners to listen to the client’s experiences and validate the client’s pain in order to establish a strong rapport for therapy.
Discussions around pain management between the client and practitioners can be difficult, and this will impact the care provided (Haverfield et al., 2018). Collaborative treatment in which the clinician and client agree on goals, roles, and treatments is recommended to improve adherence to goals and enhance overall self-management (Nøst et al., 2024). Recommended communication strategies include openness, listening, trust, and solution-oriented approaches, as well as customization of intervention plans (Haverfield et al., 2018). BIOPSYCHOSOCIAL APPROACH WITHIN THE INTERDISCIPLINARY TEAM Mescouto et al. (2022) reviewed the literature to identify the definition of the biopsychosocial model when used to treat low back pain. To be considered a biopsychosocial intervention by these authors, the study had to address aspects from each of these aspects: biological (pain education, intensity, location, posture, range of motion); psychological (behavior, cognition, attitudes, beliefs, mental health, rapport); and social (work, family relationships, socioeconomic status, and living situa- tion). Often additional components were identified—including interpersonal aspects, stigma, culture, and religion—which the authors included in a category of extensions. These authors report that many of the studies identified used a biopsycho- social model; however, in reality a biomedical, psychological, or social model was used. Ibrahim et al. (2019) assessed the long-term outcomes of a multidisciplinary biopsychosocial rehabilitation program. They found 78% of the patients were either working or ready to return to work at the 18-month follow-up. This was compared to the 64% that were unable to work at the onset of the intervention. These findings confirmed and extended the initial results of improvement at 8 months from a previous study. The program design included musculoskeletal function- ing, cognitive-behavioral components, and work-related goals and outcomes. The team was comprised of a rheumatologist, a rehabilitation physician, a pain specialist, a psychiatrist, physiotherapists, occupational therapists, and a psychologist. ROLE OF INTERPROFESSIONAL TEAM Pain is often multidimensional, interferes with every aspect of a person’s life, and requires a comprehensive assessment that will identify performance issues “more specifically identifying the supports and barriers” (AOTA, 2020, p. S21; Reeves et al., 2022). While there are a number of good assessment tools that look specifically at pain as a client factor, the reliability of these assessments to assess quality of life requires further investiga- tion (Wittkopf et al., 2017). Currently, there is no specific assessment that can be used to evaluate the biopsychosocial components of a client who is experiencing pain. Reeves et al. (2022) recommend a holistic and comprehensive approach to evaluate structural, physiological, psychological, environmen- tal, and personal factors of the individual experiencing pain.
INTERDISCIPLINARY TEAM APPROACH There is often confusion between the terms multidisciplinary and interdisciplinary . A multidisciplinary approach can be described as more than one healthcare provider (not neces- sarily at the same location) treating a client’s pain condition without necessarily coordinating care or communicating with one another. An interdisciplinary approach involves coordi- nated interventions among disciplines at the same location in an integrated manner with common goals and ongoing com- munication ( Nøst et al., 2024 ). In research and practice, these terms are often used interchangeably, and for the sake of this course, we will use the term interdisciplinary because of the need to move from discipline-specific practice to a collaborative focus on common goals. Interdisciplinary teams may include physicians, nurses, physical therapy practitioners, pharmacists, and mental health profes- sionals (Nøst et al., 2024). As part of an interdisciplinary team, practitioners can provide valuable input in the evaluation of a client’s abilities. EVIDENCE ON INTERDISCIPLINARY TEAMS When it comes to working on interdisciplinary teams, Faymon- ville et al. (2021) found the specific challenges experienced by the team include professional competence, incongruity in programing, and ability to quickly adapt and make changes. Because of these variations in the skill or experience of the clinicians and the design and intensity of the program compo- nents, it is difficult to identify the specific mechanisms that are most beneficial. Positive outcomes from the implementation of interdisciplinary teams providing several components of a biopsychosocial model include improved physical, emotional, social, and mental health ( Nøst et al., 2024 ). In addition, these teams help with decreasing pain intensity, catastroph- izing, and depressive symptoms. The results of working with an interdisciplinary team last several years. Interdisciplinary treatment is often expensive, time consuming, and resource intensive, posing a potential hardship on the client and the healthcare system; however, it provides the most effective treat- ment available at this time.
MAXIMIZING THE EFFECTIVENESS OF INTERDISCIPLINARY TEAMS
Working as part of an interdisciplinary team has its chal- lenges. Efforts to develop a coordinated team should include continuous interaction, coordinated efforts, and knowledge sharing among all members ( Nøst et al., 2024 ). Griffin and Hay-Smith (2019) found four key components to effective pain management teams: accepted team philosophy, working in the same location, having little turnover of staffing, and communication.
71
EliteLearning.com/Social-Work
Powered by FlippingBook