TY - JOUR
T1 - Trauma Trainees’ Multiple Competing Goals in Opioid Prescription Communication
AU - Adams, Elizabeth Troutman
AU - Cohen, Elisia L.
AU - Bernard, Andrew
AU - Darnell, Whittney
AU - Helme, Donald W.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Prescription opioids and heroin account for more than half of all drug overdose fatalities, costing an estimated 115 American lives every day. The ongoing opioid epidemic devastates communities and represents a tremendous burden to the national economy and health care system. In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from a traumatic injury or surgery. Trauma surgeons who prescribe opioids for severe pain embark on patient consultations with multiple and conflicting goals respective to their roles as a healers of the suffering, regulators of illicit substances, members of a greater medical system working to contain an opioid epidemic, and moral beings with a distinct set of preferences, experiences, social norms, and practice philosophies. Semistructured interviews with 17 trauma and surgical residents and fellows at a southeastern academic medical center in the United States generated descriptive data regarding prescribing practices and patient communication. Guided by the multiple goals framework, the current research presents three prominent themes depicting the problematic convergence of identity, task, and relational goals during opioid-prescribing conversations between trauma trainees and their patients.
AB - Prescription opioids and heroin account for more than half of all drug overdose fatalities, costing an estimated 115 American lives every day. The ongoing opioid epidemic devastates communities and represents a tremendous burden to the national economy and health care system. In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from a traumatic injury or surgery. Trauma surgeons who prescribe opioids for severe pain embark on patient consultations with multiple and conflicting goals respective to their roles as a healers of the suffering, regulators of illicit substances, members of a greater medical system working to contain an opioid epidemic, and moral beings with a distinct set of preferences, experiences, social norms, and practice philosophies. Semistructured interviews with 17 trauma and surgical residents and fellows at a southeastern academic medical center in the United States generated descriptive data regarding prescribing practices and patient communication. Guided by the multiple goals framework, the current research presents three prominent themes depicting the problematic convergence of identity, task, and relational goals during opioid-prescribing conversations between trauma trainees and their patients.
KW - multiple goals theory
KW - opioids
KW - patient–provider communication
KW - prescriptions
KW - qualitative interviews
KW - southeastern United States
UR - http://www.scopus.com/inward/record.url?scp=85049805308&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049805308&partnerID=8YFLogxK
U2 - 10.1177/1049732318784896
DO - 10.1177/1049732318784896
M3 - Article
C2 - 29984621
AN - SCOPUS:85049805308
SN - 1049-7323
VL - 28
SP - 1983
EP - 1996
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 13
ER -