在IBD诊所讨论疼痛时,患者和临床医生有不同的优先事项
Danielle Huisman1,2, Esther Andrews2, Amanda C de C Williams3
1Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK danielle.1.huisman@kcl.ac.uk.
BMJ open gastroenterology
|October 30, 2024
概括
炎症性肠病 (IBD) 的疼痛往往被忽视,特别是在性结肠炎中. 这项研究突出了沟通差距,并建议改善疼痛报告和对话,以改善患者护理.
科学领域:
- 胃肠病学 胃肠病学
- 疼痛管理 疼痛管理
- 患者沟通 患者沟通
背景情况:
- 疼痛是炎症性肠病 (IBD),特别是性结肠炎的重要但经常被忽视的症状.
- 患者和临床医生之间关于疼痛的非最佳沟通可能导致管理不足和患者痛苦.
研究的目的:
- 为了比较临床医生对患者疼痛的看法与IBD患者的经验.
- 为开发患者疼痛报告工具提供信息.
- 为加强关于IBD相关疼痛的沟通提供指导.
主要方法:
- 在英国,与13名IBD临床医生 (胃肠病学家,外科医生,护士,心理学家) 进行了半结构化采访.
- 用反射主题分析分析数据,比较临床医生和患者访谈中的主题 (n=71名患者,n=12名从前研究中的临床医生).
主要成果:
- 临床医生报告在克罗恩氏病时询问疼痛,但不询问性结肠炎;患者报告在两种情况下对疼痛的关注不一致.
- 权力动态和临床医生的假设 (例如,在没有明确原因时将疼痛归因于IBS) 阻碍了有效的疼痛报告和随访.
- 时间限制,系统性问题和患者不愿意表达疼痛进一步复杂化了疼痛管理.
结论:
- 在IBD护理中,一致的疼痛评估和管理至关重要.
- 临床医生和患者之间的开放和改善的对话对于有效地解决IBD疼痛至关重要.
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