ArticleBMC health services research2025
Shared-decision-making, trust in the healthcare system and health literacy are associated with self-reported pain levels: a population-based cross-sectional study in individuals living with a chronic health condition in Wales.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- (Mis)trust among patients seeking unproven stem cell therapies: a qualitative analysis.Frontiers in medicine · 2026Article
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7 authors.
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Abstract
backgroundPain is an invisible condition which has significant morbidity, mortality and healthcare system burden, and is a leading cause of disability worldwide. Pain is associated with negative health, health-system and social-economic consequences. Wales has a high prevalence of chronic pain and long waiting lists for chronic pain treatments. With the recommendation by NICE for person-centred care and the Welsh Government's A Healthier Wales and Value-Based Healthcare agendas, this study aims to assess the association between self-reported pain levels and (i) experience of shared-decision-making, (ii) perception of the healthcare system, and (iii) health literacy in adults aged 46 years old and over within Wales.
methodsThe nationally representative Population Health Survey collected patient-reported outcomes, experiences and basic demographics between July-October 2023 across Wales. The survey was deployed to adults aged 46 years old and over, online, using paper and via telephone. An adjusted linear regression, controlling for individuals and situational characteristics, was used to assess the association between self-reported pain levels in the last 7-days and (i) experience of shared-decision-making, (ii) level of trust in the healthcare system, and (iii) health literacy.
resultsA lack of shared-decision-making, lower health literacy level and lower trust in the healthcare system were all associated with an increase in self-reported pain levels. Being female, having two or more chronic health conditions, being unable to work due to sickness or ill-health, a lower education level, not drinking alcohol, lower exercise levels and poorer mental health were all individual factors associated with an increase in self-reported pain. Living in an area with a lower deprivation level was the only situational factor associated with an increase in self-reported pain.
conclusionIncreasing shared-decision-making, health literacy levels and trust in the healthcare system are modifiable factors that could have positive health outcomes in the management of chronic pain within adults aged 46 years old and over in Wales. These results have implications for the equitable future delivery of pain and chronic health conditions service within Wales, ensuring that any service meets the Welsh Government's Value-Based Healthcare approach, by delivering person-centred care.
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