During the gaining access, exploration, and appraisal stages the expenditure does not guarantee a return and at the development stage, major investments are made in the anticipation of returns over a long period of time.
It implies linking tasks executed by a health worker to supervision, performance appraisal, access to training and career development.
It is characterized by the systematic and transparent access to, and appraisal of, evidence as an input into the policymaking process [ 3, 6].
Determinants included: the priority given to pain management; information and resource seeking skills; critical appraisal skills; access to pain-related information; access to pain relief treatment; and satisfaction and preferences for practitioners and treatments.
Six contextual determinants affected the way participants choose to self-manage their chronic pain, including: priority accorded to pain management; information and resource seeking skills; critical appraisal skills; access to pain-related information; access to treatment; and satisfaction and preferences for practitioners.
Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems.
Management action, such as investment in intermediary management so that managers have the capacity to provide supportive supervision, better use of performance appraisal and access to training, may help to overcome the identified problems.
However, a standard critical appraisal tool to access the quality of studies reporting prevalence estimates needs to be developed.
Examples of performance management activities that were considered important in the study: supportive supervision, better use of performance appraisal and clearer access to training.
It would point to access barriers or different symptom appraisal and, in the long term, could contribute to the development of new health care concepts for migrants.
