确定改善在初级保健中实施综合性疼痛管理的策略
E Marshall Brooks1, Ashley Park2, Karissa Tu1
1From the Virginia Commonwealth University, Department of Family Medicine & Population Health, Richmond, VA (EMB); University of Washington, Department of Family Medicine, Seattle, WA (AP, WHTY, STT); University of Washington, School of Medicine, Seattle, WA (KT).
初级保健临床医生看到综合性疼痛管理 (IPM) 的潜力,但面临障碍. 克服教育,支付和资源方面的挑战是成功IPM整合的关键.
科学领域:
- 综合性健康是一个整体的健康.
- 疼痛管理 疼痛管理
- 主要的护理是初级保健.
背景情况:
- 越来越多的证据支持初级保健中的综合性疼痛管理 (IPM).
- 对于初级保健医生与IPM整合的经验,人们的理解有限.
研究的目的:
- 探索初级保健临床医生的经验,建议和将IPM整合到临床实践中的战略.
- 确定在初级保健机构实施IPM的障碍和促进者.
主要方法:
- 在初始招聘调查后,对14名初级保健临床医生 (MD,PA,LCSW,PharmD) 进行定性采访.
- 对转录的采访进行主题分析,以确定关键主题.
- 与来自WWAMI地区实践和研究网络的临床医生进行的研究.
主要成果:
- 临床医生强调需要在慢性疼痛治疗中进行范式转变,强调适应性.
- 确定的主要挑战包括时间限制,支付结构和资源可用性.
- 系统层面的改进和患者层面的因素也会影响IPM集成.
结论:
- 家庭医疗因其全身护理方法而处于IPM整合的良好位置.
- 与行为健康和药剂师的合作对于成功的IPM至关重要.
- 解决知识差距,改善舒适度和扩大非药物和团队为基础的护理支付是必不可少的.
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