Client experience with pain management

How clients rated how professional home care services met their pain management needs. (see data dictionary)

What do you think?

  • Why does meeting client needs for pain management matter?
  • How might this information be used to inform Continuing Care Health Service Standards 1.0 Standardized Assessment and Person-Centred Care Planning and 9.0 Staff Training, and/or related sub-standards?
  • Are there differences between zones? Between mainly rural and urban zones? What factors could account for these differences?

Whether you’re a client, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.

Understanding “experience with pain management”

In a survey conducted from October 2018 to March 2019, the HQCA asked clients receiving home care:

In the last year, professional home care services met my needs for managing my pain….

Clients could choose “Yes / Partly / No”

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (International Association for the Study of Pain, 1979).  There are many types of pain, including:

  • Acute pain – pain of recent onset and short duration that is usually due to injury or disease;
  • Chronic pain – pain that lasts or recurs for longer than 3-6 months, also known as persistent pain;
  • Transitional pain – pain that transitions from acute to chronic;
  • Cancer-related pain – a common complication of cancer that may be a result of the disease itself or due to treatment; or
  • Pain related to a palliative illness, condition, or disease (Alberta Pain Strategy, 2019).

The experience of pain is unique to each person, and involves multiple dimensions, including physical, psychological, social, emotional, and spiritual and is frequently modified by contextual factors. The complexity of pain often makes it difficult for clients and providers, within home care and other areas of the healthcare system, to work together to assess and manage pain.

This HQCA survey focused on seniors aged 65+, representing the largest group of home care clients. It is known that seniors have an increased burden of both acute and chronic pain (Davies, Higginson, & Organization, 2004; Jones & MacFarlane, 2005). From the HQCA survey results, clients felt less positive about their overall experience when they felt their needs were not met, including pain management.

Considerations when viewing the results:

This data reflects the experiences of seniors aged 65+ receiving long term supportive and maintenance care and are among the largest groups of home care clients.

There are a number of factors providers and leaders can consider to better understand and improve client experiences with pain management. To ensure alignment across areas of the healthcare system with respect to pain management, it is important to understand the Alberta Pain Strategy. Once familiar with this document, some questions they could ask before taking action include:

  • When does pain become a problem for a person and require intervention?
  • How well are professional services and treatment meeting client pain needs?
  • What are some of the challenges to effectively managing pain in older adults who have acute or chronic pain?
  • How can unmet needs around pain management affect client experience?
  • Who should a client speak with if they feel their pain is not being managed effectively? Their case manager? The nurse or other professional service staff providing this service? Their family doctor or specialist?
  • How is information shared between these parties (e.g., case manager, professional service staff, family doctor, or specialist), to ensure pain is being managed and monitored in a co-ordinated way?

For information about the HQCA’s Alberta Seniors Home Care Client Survey, please visit the HQCA website.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess home care’s performance in these dimensions of quality:
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Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety