title: Patient-centered care for chronic pain in the emergency department: A qualitative study.
abstract: Pain is a common problem for which patients seek care in the emergency department, accounting for up to 42% of all ED visits. The purpose of this study was to explore qualitatively the reasons for use of the emergency department (ED) by those frequenting the ED for treatment of chronic pain. The settings for the study were two sites of a large U.S. Midwestern healthcare system. The sample comprised patients who used the ED four or more times in the 3-month time of data collection. From a total of 85 frequent users identified through retrospective chart reviews, a computer generated random sample of patients was selected to explore their reasons for use of ED for treatment of chronic pain. Content analysis was used to identify themes from the interviews. Four themes emerged from the qualitative data analysis: time of day, pain intensity, barriers to and reasons for using the emergency department for care, and lack of individualized plan of care. Reasons patients use the ED for chronic pain are numerous and complex. Leaders of healthcare organizations must address patient-centered care, with specific alternatives to the emergency department such as individualized care plans, and care transition interventions.
authors.affiliation: College of Nursing, University of Wisconsin Oshkosh, 800 Algoma Blvd, Oshkosh, WI 54901, USA. Electronic address: jambu@uwosh.edu.
authors.forename: Jayalakshmi
authors.initials: J
authors.lastname: Jambunathan
authors.affiliation: College of Nursing, University of Wisconsin Oshkosh, 800 Algoma Blvd, Oshkosh, WI 54901, USA; Concordia University, 12800 North Lake Shore Drive, Mequon, WI 53097, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Chappy
authors.affiliation: College of Nursing, University of Wisconsin Oshkosh, 800 Algoma Blvd, Oshkosh, WI 54901, USA; Affinity Health System, 3329, N. Richmond Street, Appleton, WI 54914, USA.
authors.forename: Jack John
authors.initials: JJ
authors.lastname: Siebers
authors.affiliation: College of Nursing, University of Wisconsin Oshkosh, 800 Algoma Blvd, Oshkosh, WI 54901, USA; Aurora BayCare Medical Center, 2845, Greenbrier Road, Green Bay, WI 54311, USA.
authors.forename: Alishia
authors.initials: A
authors.lastname: Deda
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000188:drug therapy*; D004636:Emergency Service, Hospital / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000451:nursing; D018802:Patient-Centered Care / Q000379:methods*; D036301:Qualitative Research; D012189:Retrospective Studies
keywords: Care planning; Care transitions; Chronic pain; Emergency department; Individualized plan of care; Patient-centered care