培训人员在做出阿片类药物处方决定时对患者的说法:一种定性采访研究
Peter K Yi1, Melanie Kleid2, Justin Clapp3
1From the Department of Anesthesiology and Critical Care, Duke University School of Medicine, Durham, NC.
A&A practice
|January 20, 2026
概括
麻醉学学员通过初始的"红旗"和持续的临床判断来评估患者的阿片类药物滥用风险. 患者行为和社会经济因素复杂地影响阿片类药物处方决策.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 医学教育 医学教育
背景情况:
- 阿片类药物危机显著改变了疼痛管理策略.
- 医生,包括麻醉学学员,在阿片类药物处方方面面临挑战.
- 患者特定因素越来越多地影响治疗决策.
研究的目的:
- 调查麻醉学学员如何做出疼痛治疗决策.
- 了解患者特征在阿片类药物处方行为中的作用.
- 探索在临床接触期间学员判断的演变.
主要方法:
- 定性探索麻醉学学员的决策过程.
- 分析学员如何评估患者对阿片类药物滥用风险的分析.
- 检查影响疼痛管理处方选择的因素.
主要成果:
- 实习生最初使用"红旗"来衡量阿片类药物滥用潜力.
- 个体患者的相互作用和临床背景改变了最初的评估.
- 在处方方面没有观察到任何显著的种族差异.
- 医疗指示,患者行为和社会经济地位是关键因素.
结论:
- 麻醉学学员的阿片类药物处方是一个动态的过程.
- 最初的风险评估是根据个别患者的体验来改进的.
- 社会经济因素和患者行为显著影响了疼痛管理中的临床判断.
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