Access to mental health services for people living with chronic pain
Notice bibliographique
Résumé
Introduction: Chronic pain is an important global health issue, and mental health conditions frequently co-occur together. Additionally, a significant proportion of people living with chronic pain (PLWCP) may develop opioid use problems from prescribed opioid medications. Psychological interventions can have a positive effect on pain, co-occurring mental health conditions, as well as on reducing opioid medication doses. Still, access to such services is generally considered to be problematic due to barriers such as costs, stigma, and service availability. PLWCP may encounter additional access barriers due to population-specific characteristics such as pain-related distress and disability, trauma, unemployment, and more. This thesis aims to evaluate the accessibility of mental health services for PLWCP. Methods: Two studies were conducted in the context of this thesis. In the first study, a narrative review of the literature on the utilization of mental health services by PLWCP was completed. This review was based on 9 articles reporting the proportion of PLWCP that had used any type of mental health services (i.e. mental health services or consultations with mental health professionals). In the second study, an online survey to evaluate the perceived needs for mental health care (MHC) of a sample of PLWCP in Quebec was completed. The survey was distributed to members of the Quebec Chronic Pain Association, and on social media. Results: In the first study, the narrative review helped identify 9 articles, where 15 reports of mental health service utilization by PLWCP were identified. Nine of these reports pertained to the utilization of mental health services for pain-related reasons, whereas the remaining 6 reports concerned service mental health service utilization for mental health-related reasons. On average, only a quarter of study samples had used mental health services for any of the two reasons (M = 24%; 95% CI [13%-35%]). The utilization of mental health services for mental health-related reasons represented a higher proportion of participants (M = 35.6%; 95% CI [11%-60%]), than their utilization for pain-related reasons (M = 16.1%; 95% CI [9%-23%]). In the second study, a total of 140 participants were recruited. Of these, 82 participants reported a need for MHC to manage mental health problems in terms of information, medication, and counselling or psychotherapy. Results showed that only 16% of this sample indicated that all of their perceived MHC needs were met, and 40% indicated that none of their perceived MHC needs were met. Conclusions: The two studies carried out in the context of this thesis indicate that the accessibility of MHC for the chronic pain population seems to be sub-optimal. Overall, findings from this thesis suggest that the chronic pain population is not currently using mental health services to the degree to which they could benefit from them and that they may have unmet perceived needs for MHC. It is important to address these gaps to improve the treatment of chronic pain and co-occurring mental health problems, as well as to contribute to reducing the reliance on opioid medications and their negative consequences
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».