Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study

Thorough analysis of the transcripts produced two primary themes:1 pain management practices during oncology outpatient consultations and2 delivering continuity of care beyond oncology outpatient consultations (box 1). Each theme contained four subthemes to further describe the specific elements of each.

Box 1

Thematic analysis themes and subthemes

Theme 1: pain management practices during oncology outpatient consultations.

Subthemes:

1.1 Staff experience influenced pain assessment practice

Assessment of pain was influenced by HCPs seniority and experience, often using clinically based judgements to manage pain.

1.2 Variation in pain management practice

There was variation in when and how HCPs approached cancer pain management during consultations, related to time and rapport.

1.3 Remote consulting impacted pain assessment

HCPs felt remote consultations impeded even experienced HCPs ability to perform a detailed pain assessment.

1.4 HCP’s roles and responsibilities

There was variation in the extent to which HCPs felt responsible to manage cancer pain.

Theme 2: continuity of care following oncology outpatient consultations

Subthemes:

2.1 Utilisation of outpatient oncology clinical nurse specialists

HCPs felt oncology speciality nurses had more time to build rapport with patients and enable patients to openly disclose their experience of cancer pain.

2.2 Integration of supportive services

Optimal pain management involved utilising supportive services (ie, pain management teams) for advice and guidance to develop appropriate treatment pathways.

2.3 Reassessment and monitoring of cancer pain between primary and secondary care

Outpatient clinicians’ opportunity to reassess and monitor cancer pain is constrained by the frequency of appointments.

2.4 Providing patients with supported self-management plans to manage cancer pain at home

HCPs created self-management plans for patient to ensure their cancer pain was adequately reviewed.

HCPs, healthcare professionals.

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