Abstract
Aims
To explore perspectives of clinicians from interdisciplinary teams on the barriers and facilitators to chronic pain management for children and adolescents with cerebral palsy and dyskinesia.
Methods
Interdisciplinary focus groups (n = 2) were conducted at two Australian tertiary pediatric hospitals. Twenty-five experienced clinicians took part, including ten physiotherapists, six pediatricians, four rehabilitation physicians, four occupational therapists, and one speech and language therapist. An external moderator conducted the focus groups and data were analyzed using inductive thematic analysis.
Results
Four key themes emerged: “balancing the intersection of pain and dyskinesia,” “difficulty communicating between so many providers,” “uncertainty surrounding chronic pain education,” and “differing priorities.” Key barriers were identified including a lack of access to some interdisciplinary team members and formalized guidance for health professionals regarding chronic pain education.
Conclusion
Key issues were reported to impact the delivery of coordinated inter-disciplinary chronic pain management at the tertiary level for children and adolescents with cerebral palsy and dyskinesia. In the absence of strong evidence, a strategy for implementing effective chronic pain management for children and adolescents with cerebral palsy and dyskinesia and gaining clinician consensus regarding the best practice management are recommended.
Acknowledgements
The authors would like to thank Adrienne Wiebusch (consumer advisor), Ms. Mahek Dudhwala (Victorian Paediatric Rehabilitation Service, Monash Children’s Hospital), Dr. Kate Willoughby (The Royal Children’s Hospital), Associate Professor Adam Scheinberg (Victorian Paediatric Rehabilitation Service, The Royal Children’s Hospital) for their contributions and in-kind support of this study.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Clare McKinnon
Dr Clare McKinnon, PhD, is a Physiotherapist and Honorary Fellow with the Neurodisability and Rehabilitation Group at the Murdoch Children's Research Institute, Victoria, Australia.
Jennifer White
Dr Jennifer White, PhD, is an Occupational Therapist and Senior Research Fellow at the Research Centre for Generational Health, University of Newcastle, New South Wales, Australia.
Prue Morgan
Professor Prue Morgan, PhD, is the Head of Physiotherapy, Department of Physiotherapy, Monash University, Victoria, Australia.
Adrienne Harvey
Associate Professor Adrienne Harvey, PhD, is a Physiotherapist and Senior Research Fellow with the Neurodisability and Rehabilitation Group, Victoria, Australia.
Catherine Clancy
Ms. Catherine Clancy is a Physiotherapist with the Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Clayton, Victoria, Australia. She also works in private practice at Centre of Health, Ivanhoe, Victoria, Australia.
Michael Fahey
Associate Professor Michael Fahey, MBBS, PhD, is the Head of Pediatric Neurology at Monash Children's Hospital, Victoria, Australia.
Giuliana Antolovich
Dr Giuliana Antolovich, MBBS, FRACP, PhD, is a Consultant Pediatrician at the Royal Children's Hospital Melbourne. She is also an Honorary Fellow at Murdoch Children's Research Institute and Senior Fellow with the Department of Paediatrics, University of Melbourne, Victoria, Australia.