老年人慢性疼痛的非药物干预:系统性审查和元分析
Dara Kiu Yi Leung1, Annabelle Pui Chi Fong1, Frankie Ho Chun Wong1,2
1Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China.
The Gerontologist
|February 17, 2024
概括
非药物干预,特别是与身体活动相结合的心理方法,对老年人慢性疼痛提供了小但显著的好处. 这些方法有助于减少疼痛强度和改善身体功能,支持恐惧回避模型.
科学领域:
- 老年学是指老年学的学科.
- 疼痛管理 疼痛管理
- 心理学 心理学 心理学
背景情况:
- 生物心理社会因素影响慢性疼痛,正如门控制理论和恐惧回避模型所建议的那样.
- 建议在慢性疼痛中进行非药物干预,但它们在老年人中的有效性需要进一步研究.
研究的目的:
- 系统地审查和比较各种非药物干预措施在老年人慢性疼痛管理方面的有效性.
- 进行元分析和子组分析,以评估干预的有效性.
主要方法:
- 在MEDLINE,Embase和PsycINFO进行了系统的文献搜索,遵守PRISMA指南.
- 包括患有慢性疼痛的老年人随机对照试验,并使用随机效应元分析模型进行分析.
- 用心理干预的质量评级表来评估偏见风险.
主要成果:
- 分析了25项与2394名参与者的试验,将6项非药物干预与对照条件进行比较.
- 非药物干预表明,疼痛强度,疼痛干扰,抑郁症状和灾难性的信念显著减少.
- 观察到身体表现的改善,心理方法与体育活动相结合,显示出特别的好处.
结论:
- 非药物干预,特别是那些整合心理策略和体育活动的干预,在老年人慢性疼痛管理中产生了小但统计学上显著的改善.
- 减少疼痛干扰可能与减少灾难化有关,支持恐惧回避模型.
- 需要进一步进行高强度的研究,以阐明不同干预模式在这个人群中的有效性和机制.
相关概念视频
01:25Analgesia and Pain Management
623
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
623
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
3.8K
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
3.8K
01:27Insomnia
85
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
85
01:03Nursing Interventions I: Taxonomy of Nursing Interventions
2.6K
Nursing interventions are chosen as part of the planning process to achieve patient outcomes. Once nursing diagnoses are determined, the goals and outcomes are specified, then the nursing interventions are selected and individualized according to the patient's situation.
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
2.6K
01:44Nociception
27.9K
Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
27.9K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
250
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
250