使用阿片类药物的慢性疼痛患者:具有挑战性的治疗选择,共享决策者或风险制定者? 对比利时政策文件的批判性话语分析
Lena De Bonte1, Justine Vanbavinckhove1, Liesbet Goubert1
1Ghent University, Belgium.
Health (London, England : 1997)
|October 2, 2025
概括
比利时关于慢性疼痛管理的政策文件揭示了三个关键话语:医疗权威,患者赋权和高风险药物. 这些塑造了关于如何在非癌症疼痛中讨论阿片类药物的使用.
科学领域:
- 公共卫生 公共卫生
- 社会学 社会学 社会学
- 医学人文学科 医学人文学科
背景情况:
- 慢性疼痛影响到25%的比利时成年人,提出复杂的管理挑战.
- 对慢性非癌症疼痛的阿片类药物的疗效有限,导致政策转向远离它们的使用.
- 现有文献强调,需要了解关于在慢性疼痛中使用阿片类药物的政策观点.
研究的目的:
- 分析比利时政策文件如何描绘患者,医疗保健提供者和治疗关系,涉及使用阿片类药物治疗慢性非癌症疼痛.
- 探索在慢性疼痛管理中塑造阿片类药物使用政策的基本话语.
主要方法:
- 32份荷兰语的比利时政策文件的批判性话语分析.
- 应用Fairclough的框架来检查政策文本中的语言,权力动态和意识形态.
主要成果:
- 确定了三个主要话语:医疗权威,患者赋权和高风险药物.
- 医学权威话语优先考虑医生的决策.
- 患者赋权话语侧重于患者的经验和偏好.
- 高风险药物话语强调阿片类药物成的潜力.
结论:
- 这些话语虽然承认生物心理社会模式,但在慢性疼痛管理和阿片类药物使用方面提出了不同的观点.
- 政策文本构建和挑战治疗关系和围绕慢性疼痛和阿片类药物治疗的耻辱.
- 结果为比利时疼痛管理政策的演讲构建提供了关键的见解.
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