Pain assessment and treatment in bleeding disorders: The need for social work specific education

Abstract

The aim of this research was to examine what social workers currently understand and practice in pain management, specifically in bleeding disorder care. First, a scoping review was conducted to examine the breadth of research relevant to social work in pain management and bleeding disorders. Second, qualitative interviews were conducted with members of the Canadian Social Workers in Hemophilia Care (CSWHC) to identify the current state of understanding of the social work role in pain management and to explore the requirements for future pain education. The research question for the scoping review was: What do social workers currently contribute to pain management in patients at risk of pain with chronic disease? In total, there were 13 articles included. These articles discussed three core social work interventions utilized in pain management practice: instrumental services, counselling services, and assessments. Advocacy and policy development were noted in a small number of these studies and require further development and research. To address the overall aim of this project, qualitative interviews were conducted with 12 members of the CSWHC and examined using thematic analysis. The two research questions guiding the inquiry were: 1) What do social workers in the CSWHC currently understand about pain and bleeding disorder care and their practice, and 2) What specific pain knowledge and training is prioritized by social workers in the CSWHC. Four themes were developed: 1) Limited comprehension of key issues related to pain; 2) Conditioned to push through pain; 3) Expanding pain knowledge to enhance practice; 4) How we practice social work and choose to step in. The findings from each study were synthesized and indicated there are common elements of the social work role in pain management and bleeding disorder care. While assessments were identified in both studies, the types of assessments explicitly used in pain management require further study. This study identified that future education and research is required in knowledge of pain mechanisms, assessments specific to pain, and the awareness of non-pharmacological pain interventions. Advocacy and policy development require further development in the understanding and function of daily practice.