Abstract
Chronic pain affects 1 in 5 youth, many of whom manage their pain using a biopsychosocial approach. The COVID-19 pandemic has impacted the way that healthcare is delivered. As part of a larger program of research, this study aimed to understand the impact of the pandemic on pediatric chronic pain care delivery including impact on patients’ outcomes, from the perspective of pediatric healthcare providers. A qualitative descriptive study design was used and 21 healthcare providers from various professional roles, clinical settings, and geographic locations across Canada were interviewed. Using a reflexive thematic analysis approach 3 themes were developed: (1) duality of pandemic impact on youth with chronic pain (i.e., how the pandemic influenced self-management while also exacerbating existing socioeconomic inequalities); (2) changes to the healthcare system and clinical practices (i.e., triaging and access to care); (3) shift to virtual care (i.e., role of institutions and hybrid models of care). These findings outline provider perspectives on the positive and negative impacts of the pandemic on youth with chronic pain and highlight the role of socioeconomic status and access to care in relation to chronic pain management during the pandemic in a high-income country with a publicly funded healthcare system.
Highlights
Chronic pain affects approximately 1 in 5 youth [1], impacting all domains of life including academic [2,3,4], psychosocial [5], and physical functioning [6]
Our analysis highlighted 3 main themes related to this experience from the perspective of HCP: (1) the duality of the impact of the COVID-19 pandemic restrictions on youth with chronic pain; (2) changes to the healthcare system and clinical practices; (3) the shift to virtual care among pediatric pain HCP
The COVID-19 pandemic impacted pediatric chronic pain care providers and care delivery in a variety of ways. These results highlight the challenges of continuing to provide pain care during a pandemic and outlines the potential opportunities in utilizing virtual care and developing hybrid models of care to increase accessibility of chronic pain care. These results present an opportunity for a call to action for the pediatric chronic pain community
Summary
Chronic pain affects approximately 1 in 5 youth [1], impacting all domains of life including academic [2,3,4], psychosocial [5], and physical functioning [6]. Youth may be referred to a pediatric multidisciplinary chronic pain clinic (PMCPC) or an intensive rehabilitation program when community level interventions are not enough to achieve optimal pain management and improved function These multidisciplinary programs commonly have a team which includes a medical doctor (e.g., pain physician, anaesthesiologist, or paediatrician), physical therapist, psychologist and/or psychiatrist, and a registered nurse or nurse practitioner. Key components include joint goal setting with emphasis on functional rehabilitation (e.g., school attendance, fitness goals, stress management) and active strategies to support pain self-management [11] The goal of this interview is to understand how the COVID-19 pandemic (coronavirus) has been impacting your work caring for young people living with chronic pain.
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