在照顾和与接受阿片类药物治疗的慢性疼痛患者时,有目的的共享决策
Nafisseh S Warner1, Michele J Buonora2,3, Benjamin Lai4
1Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. warner.nafisseh@mayo.edu.
Journal of general internal medicine
|May 9, 2025
概括
共享决策 (SDM) 对于慢性疼痛管理至关重要. 有目的的SDM,一种协作方法,确保以患者为中心的护理,避免伤害,即使是长期的阿片类药物治疗.
科学领域:
- 疼痛管理 疼痛管理
- 临床决策 - 临床决策
- 公共卫生 公共卫生
背景情况:
- 疾病预防控制中心的指导方针建议在长期疼痛阿片类药物处方方面进行共享决策 (SDM).
- 有关阿片类药物的有效性,长期治疗对决策能力的影响和转移存在担忧.
- 慢性疼痛护理需要对疼痛的影响和治疗目标有共同的理解.
研究的目的:
- 定义和倡导有目的的SDM作为以患者为中心的慢性疼痛护理的框架.
- 强调有目的的SDM的实用性,无论阿片类药物处方.
- 解决监管工具对SDM和患者与临床医生关系的潜在负面影响.
主要方法:
- 基于协作护理原则的概念框架开发.
- 对SDM,慢性疼痛和阿片类药物处方现有文献的分析.
- 讨论监管措施在SDM中的作用.
主要成果:
- 有目的的SDM是慢性疼痛管理的有用和可用的框架.
- 患有慢性疼痛或长期服用阿片类药物治疗的患者可以参加有目的的SDM.
- 惩罚性的监管工具可能会破坏信任和SDM的可能性.
结论:
- 有目的的SDM促进了合作,非惩罚性的患者与临床医生的关系.
- 该框架支持量身定制的慢性疼痛护理,同时减轻意外伤害.
- SDM对于有效和道德的慢性疼痛管理至关重要.
相关概念视频
Analgesia and Pain Management
398
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...
398
Opioid Analgesics: Synthetic and Semisynthetic Opioids
172
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
172
Chronic Pancreatitis II: Collaborative Care
49
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
49
Opioid Analgesics: Morphine and Other Natural Cogeners
138
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...
138
Chronic Obstructive Pulmonary Disease-V: Nursing Management
3.4K
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
3.4K
Ethical Dilemmas II
850
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
850


