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Understanding pain specialists’ decision-making on prescription of opioids for chronic non-cancer pain

Lee Li Qing, Bernice; (2019) Understanding pain specialists’ decision-making on prescription of opioids for chronic non-cancer pain. Doctoral thesis (D.Clin.Psy), UCL (University College London). Green open access

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Abstract

Part 1 comprises a systematic review of the exploration of psychological variables in surveys on beliefs of physicians on opioids for chronic non-cancer pain. Fifteen papers met the study criteria and were reviewed. Psychological variables were studied in nine studies and are categorized into two themes – ‘confidence and comfort’ and ‘trust and ambivalence’. Evidence for the influence of psychological variables on decision-making on opioid prescribing is poor. // Part 2 describes an empirical paper investigating the factors, including patients’ and physicians’ emotions, influencing the decision-making processes of pain specialists (N = 14) treating patients with chronic non-cancer pain using opioids. Thematic analysis yielded six themes: 1. Adhering to best practice; 2. Thorough understanding and application of expertise on opioids; 3. Paying attention to patient factors; 4. Maintaining doctor-patient relationship; 5. Clinicians’ emotions have little bearing on decisions; and 6. Recognising limitations of current prescribing climate. The findings suggest that both patients’ and clinicians’ emotions have some influence on clinicians’ decisions in the management of chronic pain. // Part 3 is a critical appraisal that discusses the challenges encountered during the research process, examines the underlying assumptions and concludes with reflections on conducting qualitative research.

Type: Thesis (Doctoral)
Qualification: D.Clin.Psy
Title: Understanding pain specialists’ decision-making on prescription of opioids for chronic non-cancer pain
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10084918
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