慢性疼痛患者的困难遭遇:一个队列研究
Steven P Cohen1, Winnie L Liu2, Tina L Doshi3
1Departments of Anesthesiology, Neurology, Physical Medicine and Rehabilitation, Psychiatry and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Departments of Anesthesiology and Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD; Deparments of Anesthesiology & Critical Care Medicine, Neurology, Physical Medicine & Rehabilitation and Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
疼痛管理中的困难临床遭遇往往与访问相关的因素有关,例如沟通问题和不切实际的患者期望,而不仅仅是患者的病史. 进一步的研究应该探索改善这些相互作用的干预措施.
科学领域:
- 疼痛医学 医学 疼痛医学
- 临床心理学 临床心理学
- 医疗保健管理的管理
背景情况:
- 了解导致困难临床遭遇的因素对于改善患者护理和医生福祉至关重要.
- 以前的研究已经探索了各种患者和访问相关的因素,但在疼痛管理设置中的特定关联需要进一步阐明.
研究的目的:
- 在疼痛管理环境中识别与医生感知困难的临床遭遇相关的人口,临床,社会和访问相关的变量.
主要方法:
- 一项涉及428名新的疼痛患者及其医生的横截面研究.
- 收集的数据包括患者的人口统计学,社会史,访问特征,以及医生对6点利克特级别遇到困难的评分.
主要成果:
- 多变量分析显示,请求阿片类药物,比预期更长的访问,敌对行为,拒绝推治疗,不切实际的期望和沟通困难与困难的遭遇有显著的关联.
- 医生和患者的人口统计学,如性别,种族和医生经验,与遭遇困难无关.
结论:
- 与访问相关的因素,而不是某些患者特定的社会历史因素,在定义疼痛管理中的困难遭遇方面似乎更有影响力.
- 未来的研究应该专注于开发和评估干预措施,以减轻遇到的困难,并评估它们对患者和医生的影响.
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