A qualitative exploration of emergency clinicians’ experiences of caring for patients experiencing back pain

Capsey, Matt ORCID: https://orcid.org/0000-0003-3659-5344 , Ryan, Cormac, Mankelow, Jagjit and Martin, Denis (2024) A qualitative exploration of emergency clinicians’ experiences of caring for patients experiencing back pain. In: British Pain Society 57th Annual Scientific Meeting, 4-6 June 2024, Nottingham, UK.

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Abstract

Background: Patients who present to emergency care experiencing back pain have a wider range of underlying causes, including higher rates of serious pathology. Clinical guidelines tend to focus on primary care citing low rates of serious pathology and advocating conservative management of chronic non-specific back pain. These guidelines appear difficult to apply to emergency care, but little is known about emergency clinicians’ experiences of delivering care to this patient group.

Aims: The primary aim of this study was to explore the experiences of emergency clinicians in caring for patients experiencing back pain.

Objectives of the study were to explore:
• Understanding of the term “back pain”.
• Perceptions of whether these patients make up a significant proportion of the clinicians’ case load.
• The care that clinicians provide and their confidence in offering that care.
• Opinions of what, if anything, would improve care for this patient group.

Methods: The study was a qualitative exploration using reflexive thematic analysis as described by Braun and Clarke. Data collection took the form of 13 semi-structured interviews with a range of emergency clinicians. The interviewer, and primary coder, (MC) is an experienced academic paramedic with an insider position in relation to emergency care. The interviews were transcribed and analysed by the primary researcher (MC) with other members of the research team (CR, JM, DM) providing oversight and review.

Results: Thirteen interviews were conducted with a range of emergency clinicians (doctors, paramedics, nurses and physiotherapists) four themes and ten sub-themes were constructed. The four themes were: “Understanding Back Pain”, “EMS can be a legitimate choice for patients”, “Benign or Sinister?” and “Treatment Options”.

Key Points:
• The backpain population presenting to emergency care is different
• There are higher rates of serious and non-spinal pathologies in emergency care
• Emergency clinicians are the “back stop” for the rest of healthcare, but are mostly confident and feel supported by specialist colleagues
• Non-advocated treatments are often used when attending patients in acute crisis in their own home
• Entonox can be beneficial, but cannot be used long-term, and has no evidence base
• Less-experienced clinicians make most use of guidance and it should include the challenges of managing undifferentiated cases.

Item Type:	Conference or Workshop Item (Poster)
Departments:	Institute of Health > Centre for Excellence in Paramedic Practice
Additional Information:	Poster abstract published in British Journal of Pain, Vol. 18 (1) (suppl. 1), Aug 2024, https://doi.org/10.1177/20494637241265561.
Depositing User:	Anna Lupton
Date Deposited:	04 Oct 2024 09:12
Last Modified:	04 Oct 2024 09:15
URI:	https://insight.cumbria.ac.uk/id/eprint/8431

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