Weinstein S M, Laux L F, Thornby J I, Lorimor R J, Hill C S, Thorpe D M, Merrill J M
Department of Neuro-Oncology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
South Med J. 2000 May;93(5):479-87.
Despite extensive progress in the scientific understanding of pain in humans, serious mismanagement and undermedication in treating acute and chronic pain is a continuing problem. This study was designed to examine the barriers to adequate pain management, especially as they might be associated with community size and medical discipline.
A 59-item survey was used to measure physicians' attitudes, knowledge, and psychologic factors that contribute to pain management practices.
Overall, a significant number of physicians in this survey revealed opiophobia (prejudice against the use of opioid analgesics), displayed lack of knowledge about pain and its treatment, and had negative views about patients with chronic pain. There were significant differences among groups of physicians based on size of geographic practice area and medical discipline.
New educational strategies are needed to overcome these barriers and to improve pain treatment in routine medical practice. The effect of practice milieu must be taken into consideration.
尽管在对人类疼痛的科学理解方面取得了广泛进展，但在治疗急性和慢性疼痛时严重的管理不善和用药不足仍是一个持续存在的问题。本研究旨在探讨充分疼痛管理的障碍，尤其是那些可能与社区规模和医学学科相关的障碍。
采用一项包含59个条目的调查来衡量医生对疼痛管理实践有影响的态度、知识和心理因素。
总体而言，本次调查中有相当数量的医生表现出对阿片类药物的恐惧（对使用阿片类镇痛药的偏见），对疼痛及其治疗缺乏了解，并且对慢性疼痛患者持负面看法。基于地理执业区域规模和医学学科的医生群体之间存在显著差异。
需要新的教育策略来克服这些障碍，并改善常规医疗实践中的疼痛治疗。必须考虑执业环境的影响。
