Publications by authors named "Chelsea R Chapman"

2 Publications

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Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: a Qualitative Systematic Review and Meta-Synthesis.

Phys Ther 2022 Jun 30. Epub 2022 Jun 30.

School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, San Diego State University, San Diego, CA USA.

Objective: Lack of clarity regarding effective communication behaviors in chronic pain management is a barrier for implementing psychologically informed physical therapy approaches that rely on competent communication by physical therapist providers. This study aimed to conduct a systematic review and meta-synthesis to inform the development of a conceptual framework for preferred communication behaviors in pain rehabilitation.

Methods: Ten databases in the health and communication sciences were systematically searched for qualitative and mixed-method studies of interpersonal communication between physical therapists and adults with chronic pain. Two independent investigators extracted quotations with implicit and explicit references to communication and study characteristics following Standards for Reporting Qualitative Research and STROBE guidelines. Methodological quality for individual studies was assessed with CASP, and quality of evidence was evaluated with GRADE-CERQual. An inductive thematic synthesis was conducted by coding each quotation, developing descriptive themes, and then generating behaviorally distinct analytical themes.

Results: Eleven studies involving 346 participants were included. The specificity of operationalizing communication terms varied widely. Meta-synthesis identified 8 communication themes: (1) disclosure-facilitating, (2) rapport-building, (3) empathic, (4) collaborative, (5) professional accountability, (6) informative, (7) agenda-setting, and (8) meta-communication. Based on the quality of available evidence, confidence was moderate for 4 themes and low for 4 themes.

Conclusion: This study revealed limited operationalization of communication behaviors preferred by physical therapists in chronic pain rehabilitation. A conceptual framework based on 8 communication themes identified from the literature is proposed as a preliminary paradigm to guide future research.
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June 2022

Patient-Initiated Pain Expressions: Interactional Asymmetries and Consequences for Cancer Care.

Health Commun 2020 11 30;35(13):1643-1655. Epub 2019 Aug 30.

School of Communication.

Only minimal attention has been given to analyzing interactional moments when patients and providers talk about "pain" in general consultations and primary care, and no attention has focused on how pain gets managed during oncology interviews. Conversation analysis (CA) is used to examine a sampling of instances drawn from a collection of 146 pain instances across 65 video recorded and transcribed clinical encounters in a comprehensive cancer clinic. Specific attention is drawn to how pain descriptions are not static but malleable as cancer patients upgrade, downgrade, and produce combined orientations when making their experiences available to oncologists. In response, it is shown that doctors acknowledge patients' descriptions, but do not elaborate nor affiliate with, important pain disclosures. Three interactional environments are closely examined: 1) Reporting and responding to past pain/hurt incidents; 2) Doctor's missing assessments in response to good news announcements about patients' minimal pain; and 3) Patient-initiated pain responses to doctors' questions. These empirical findings confirm identified patterns of interactional asymmetries comprising pain events in UK consultations and USA primary care. Close examination of these social actions provides basic knowledge about how pain communication reframes historical understandings of individuals' pain experiences. Implications for future research are identified, and a protocol is described for how clinical practice and medical education can be improved by refining understandings of pain communication to promote increased sensitivities and more personalized responses to pain expressions.
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November 2020