慢性疼痛,药物使用和初级护理经验之间的关联在退伍军人中持续或最近的无家可归
Allyson L Varley1, Aerin J DeRussy2, Audrey L Jones3,4
1Birmingham VA Health Care System, 700 19th Street South, Birmingham, AL, 35233, USA. avarley@uab.edu.
Journal of general internal medicine
|October 15, 2024
概括
慢性疼痛显著恶化了退伍军人无家可归经验 (VHE) 的初级保健体验. 改善患者提供者信任和沟通对于更好的医疗保健结果至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 退伍军人健康的医疗服务
- 疼痛管理 疼痛管理
背景情况:
- 慢性疼痛和物质使用在无家可归的退伍军人中很常见.
- 这些情况可能会对VHE的初级保健体验产生负面影响.
- 了解这些关联对于提高护理质量至关重要.
研究的目的:
- 调查VHE中慢性疼痛,物质使用和负面的初级保健经验之间的联系.
- 探索疼痛治疗利用如何影响慢性疼痛的VHE之间的护理经验.
主要方法:
- 在29个VA医疗中心调查了3039个VHE,使用验证的初级保健质量-无家可归者 (PCQ-H) 尺度.
- 使用后勤回归来分析护理经验与慢性疼痛/物质使用之间的关联.
- 确定了在不满意度上存在最大差异的特定PCQ-H项目.
主要成果:
- 慢性疼痛的VHE在所有尺度上报告了显著更高的不利初级保健体验.
- 长期使用阿片类药物和职业治疗与慢性疼痛的VHE患者的不良体验较少相关.
- 与信任,关系和提供商沟通相关的项目不满意度最高.
结论:
- 慢性疼痛是VHE初级保健体验不佳的重要驱动因素.
- 增强患者提供者信任,沟通和获得有效的疼痛治疗是必不可少的.
- 这些改进可能会为这个弱势群体带来更好的医疗保健结果.
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