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Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Abstract
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Chronic pain affects millions of Americans and can be addressed through multiple modalities, interventions, and strategies. Yoga and self-management have been proven effective in treating chronic pain, but little research has been conducted on the feasibility and implementation barriers related to these alternative intervention forms. In our qualitative study, we examined staff perceptions regarding the feasibility of implementing yoga along with established self-management at a pain management clinic in Colorado. We utilized the Implementation Drivers of Competency, Organizational, and Leadership, and our added Hypothetical Driver to explore barriers and facilitators related to project implementation. Our findings suggest that positive staff and patient attitudes were crucial for successful implementation. We also identified physical space, transportation, and supportive leadership as necessary components of project implementation. Further research is needed to examine barriers such as funding to ensure intervention sustainability and the need for adequate staffing.
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
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2. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Introduction
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Purpose of Study
To investigate project staff perspectives regarding the implementation of our yoga intervention into ongoing self-management at the pain clinic.
Evaluation Questions
Covered the strengths and barriers to implementation was well as how the intervention could be modified to improve implementation with established self-management programming.
Chronic Pain
Nearly 50 million US adults suffer from chronic or sever pain [1]
Female, low income (<$25,000), less education (<high school), divorce higher risk [2]
Impairs functioning (cognitive and physical ability) and affects qualify of life [3,4]
Combined Intervention
Limited information on feasibility of implementing a yoga intervention paired with self-management in a clinical setting
Literature focuses on perceptions of individuals with chronic pain toward engaging in self-in self-management [5,6,7]
Self-Management
Ability to manage symptoms, treatment, physical and psychological, and lifestyle changes of living with a chronic condition [8]
Yoga
Modalities vary but typically include physical postures, breathing techniques, and meditation
Reduce functional disability and pain intensity and supports mental health [9]
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

3. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Methods
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Qualitative Case Study
Conducted at a pain management clinic in Colorado
Pain management clinic’s mission is to help patients function better in their daily lives
Sample
Purposeful sample with a total of 13 project staff
Multidisciplinary team including doctors, nurses, clinicians, yoga instructors, and occupational therapy research assistants
Measures
Our focus was project staff’ responses, opinions, and attitudes related to the implementation of our yoga intervention with established self-management programming
Semi-structured interviews with open ended questions were utilized to allow for follow up questions [10]
Data Collection and Management
Seven Individual interviews and one focus group were conducted in January and February 2016
These interviews/focus group were digitally audio recorded, with an average length of 30 minutes, then transcribed for use in analysis
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

4. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Figure 1
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

5. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Figure 2
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

6. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Results
Abstract
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Competency Drivers
Leadership Drivers
Skills and attitudes of staff and patients that impact the delivery of services
Level of support for intervention by leadership and ability to address funding concerns that relate to the sustainability of the intervention
Support after training
Comfort with topic
Intervention coordinator
Rapport with participants
Executive committee
Intervention training
Technical
Knowledge
Time
Belief in usefulness
Funding
Staff attitudes
Motivation
Receptivity to training
Clinical inertia
Organizational Drivers
Hypothetical Barriers
Structural elements of the intervention and organization that impact the delivery of services
Factors that may impact continued or other implementation in other clinical settings        
Systems Intervention
Staff buy in
Managerial support
Affordability
Facilitative Administration
Intervention structure
Immediate appointment
Nurse/time
Caseload
Decision Support Data System
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

7. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Results
Abstract
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Quotes
Competency Barriers
“the staff that already overworked and supportive you know, may not want to add something new to their, what they’re already doing”
Competency Facilitators
“you need to have understanding. You have to knowledge and belief for the people who are trying to do it that it’s going to make a difference”
Organizational Barriers
“turf battles for space from a department that wasn’t our department using space and fears that once one department starts using the space…then next thing it won’t be our classroom anymore”
Organizational Facilitators
“I think that if we were still at that point with the pain clinic where it was just part of the regular system, and then tried to bring in the yoga program, I don’t think it would work…we now have the dedicated phone, front desk and nursing staff we were able to do the yoga program”
Leadership Barriers
“We need funding somehow to make it happen”
Leadership Facilitators
“I think you just have to have like a point person who’s totally bough into the idea of it and who’s willing to have it kinda consume their job”
Hypothetical Barriers 
“If you don’t have somebody who is personally motivated about it, who feels strongly about it, I could see if showing up as a burden”
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content

8. Click headings to further view content
Staff Perspectives Regarding Implementing a Yoga Intervention with Chronic Pain Self-Management in a Clinical Setting
Emily Waddington, MSW; Reid Rogers Fuller, MSW; Rachel Barloon, MSW; Grace Comiskey, MSW; Jennifer Dickman Portz, PhD; Helen Holmquist-Johnson, PhD; Arlene Schmid, Phd, OTR/L, RYT-200
Colorado State University, College of Health and Human Sciences, School of Social Work and Department of Occupational Therapy
Abstract
Conclusion
Figures
Keywords
Chronic Pain
Yoga
Self-Management
Staff Perspectives
Implementation
Clinical Setting
Figure 1: Data Analysis
Figure 2: Implementation Drivers
Based on our study, it is feasible to implement yoga paired with self-management as a method of addressing chronic pain in a clinical setting. For successful implementation, it is important to consider both barriers and facilitators. There is a need to create a climate accepting of complementary therapies as well as cultivating staff belief in the intervention itself. Further research into contributing factors of staff perceptions, staff-patient relationships, and staff buy-in of yoga is necessary to address hiring, training, and educating staff. These are vital components to the feasibility of implementing yoga as an intervention to address chronic pain in a clinical setting.
Key Facilitators
Positive staff and patient attitudes were crucial for successful implementation of yoga with chronic pain self-management.
Physical space, transportation, and supportive leadership as necessary components of project implementation.
Key Barriers
Negative attitudes about yoga and staffing issues, particularly related to training, were barriers to program implementation.
Results
Competency Drivers
Organizational Drivers
Leadership Drivers
Hypothetical Barriers
Introduction
Purpose of Study
Evaluation Questions
What were the strengths of implementing yoga?
What were the barriers to implementation?
How could the yoga intervention be modified to improve implementation?
Literature Review
Conclusions
Feasibility for Implementation
Key Facilitators
Positive staff and patient attitudes
Physical space, transportation, and supportive leadership
Key Barriers
Negative attitudes about yoga, staffing issues, and training
Methods
References
Qualitative Case Study
Sample
Measures
Data Collection and Management
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Click headings to further view content