Wasan Ajay D, Wootton Joshua, Jamison Robert N
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Reg Anesth Pain Med. 2005 Mar-Apr;30(2):184-92. doi: 10.1016/j.rapm.2004.11.005.
Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. This article helps practitioners to identify those pain patients who would be prone to difficult behavior and sheds light on some of the reasons behind the behavior that give rise to difficult feelings. Issues of comorbid psychopathology, hostility, suicidality, aberrant drug behavior, and chronic noncompliance are discussed. Specific recommendations are also given of the best ways to manage patients with difficult behavior.
疼痛患者可能很难缠。他们会在临床医生中引发沮丧和愤怒等负面情绪，破坏医患关系。本文帮助从业者识别那些容易出现难缠行为的疼痛患者，并阐明导致这种难缠情绪的行为背后的一些原因。文中讨论了共病精神病理学、敌意、自杀倾向、异常药物行为和慢性不依从性等问题。还给出了应对难缠行为患者的最佳方法的具体建议。
