Attitudes and Beliefs Regarding Pain in Interprofessional Education: A Multifaceted Dilemma

Purpose: To evaluate entry-level physical and occupational therapy student attitudes and beliefs toward treating a person with pain, at various levels of their didactic learning. Description: Across health professions, pain education varies considerably with its curricula of pain definitions, management principles, and interprofessional collaboration. The result of this discord has led to a broad range of behaviors and attitudes among health professions and their students, which can ultimately affect a person’s participation in society. Literature supports the importance of a curriculum that addresses students’ attitudes and beliefs toward treating people in pain in an attempt to preclude the formation of negative attitudes during clinical practice. Summary of Use: A modified open-ended sentence stem format was used to gather the qualitative data of 241 graduate students enrolled in occupational and physical therapy entry-level programs to assess their knowledge and attitudes toward pain. Students completed a questionnaire including two open-ended sentence stems. Verbatim transcripts of the students’ responses were thematically analyzed by five-blinded faculty, who constructed nine themes that reflected students’ responses. Interrater reliability was strong with an average of 89.4% agreement rating (range 68.1-97.6%). Analysis of the responses to the first stem, “People in pain are…” yielded four themes: 1) negative mood sate (suffering/unhappy); 2) negative trait or characteristic (wimpy/uncooperative); 3) needy; and 4) having real problems. The percentages of the students’ attitudes reflected in each theme were 28.8%, 5.1%, 42.7%, 23.4% respectively. Responses were dominated by themes related to a negative mood state and being needy. Negative attitudes toward treatment of persons in pain have been shown to contribute to disparities in pain care. Analysis of responses to the second stem question, “Working with patients in pain will be …” yielded five themes: 1) intellectually stimulating; 2) worthwhile/rewarding; 3) unpleasant/difficult; 4) challenging/complex; and 5) routine in practice. The frequency of responses were 8.3%, 33%, 19.8%, 38.9%, and 12.6% respectively and were dominated by themes suggesting that working with people in pain will be challenging yet rewarding. Importance to Member: Despite the frequency of pain problems in society, pain and the treatment of people in pain have not been major components of healthcare education. The International Association for the Study of Pain (IASP) provides a guideline for knowledge of pain management for entry-level physical and occupational therapists. Knowing what preconceived attitudes and beliefs students have in treating persons with pain can help drive the development of a pain curriculum that is both academically inclusive and behaviorally influential. As educators, we have the opportunity to address this multifaceted dilemma to meet the IASP guidelines and bridge the gap between interprofessional pain education and the optimal treatment of those in pain