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老年人尝试慢性疼痛自我管理方法时所察觉到的障碍。

Perceived barriers to trying self-management approaches for chronic pain in older persons.

作者信息

Austrian Jonathan S, Kerns Robert D, Reid M Carrington

机构信息

Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New York 10021, USA.

出版信息

J Am Geriatr Soc. 2005 May;53(5):856-61. doi: 10.1111/j.1532-5415.2005.53268.x.

Abstract

OBJECTIVES

To examine older persons' willingness to participate in exercise and relaxation programs for managing chronic pain, to identify characteristics associated with willingness to participate, and to ascertain their barriers to participation.

DESIGN

Cross-sectional survey.

SETTING

A geriatric ambulatory care practice located in New York, New York, and the General Clinical Research Center of Weill Cornell Medical College.

PARTICIPANTS

Sixty-eight English-speaking patients aged 70 and older with chronic pain.

MEASUREMENTS

Participants' level of willingness to participate in the programs was assessed using 5-point Likert scales, and information regarding their demographic, clinical, psychological, and pain status was obtained. Qualitative methods were used to ascertain participants' perceived barriers to participation.

RESULTS

Participants had a mean age+/-standard deviation of 81.9+/-7.0 and were mostly white (85%) and female (68%). Although only 16% of participants reported current use of exercise as a pain-management strategy, 73% reported a willingness to try the exercise program. Four percent reported current use of relaxation methods; 70% reported an interest in learning these techniques. Moderate correlations were found between increasing days of restricted activity due to pain and greater willingness to participate. Seventeen unique barriers were identified; the mean number of barriers reported per person was 2.9+/-1.8 for exercise and 2.2+/-1.4 for relaxation. Commonly reported barriers to participating in either program included time conflicts, transportation, treatment efficacy concerns, and fear of pain or injury.

CONCLUSION

Older primary care patients with chronic pain are willing to try exercise and relaxation therapies to help manage pain but report a substantial number of barriers to participating in these programs. Addressing patient-level barriers could improve engagement in and adherence to exercise and relaxation therapies for managing pain in older persons.

摘要

目的

研究老年人参与慢性疼痛管理的运动和放松项目的意愿,确定与参与意愿相关的特征,并查明他们参与的障碍。

设计

横断面调查。

地点

位于纽约的一家老年门诊护理机构以及威尔康奈尔医学院的综合临床研究中心。

参与者

68名年龄在70岁及以上、讲英语且患有慢性疼痛的患者。

测量

使用5点李克特量表评估参与者参与项目的意愿程度,并获取有关其人口统计学、临床、心理和疼痛状况的信息。采用定性方法确定参与者感知到的参与障碍。

结果

参与者的平均年龄±标准差为81.9±7.0岁,大多数为白人(85%)且为女性(68%)。虽然只有16%的参与者报告目前将运动作为疼痛管理策略,但73%的参与者表示愿意尝试运动项目。4%的参与者报告目前使用放松方法;70%的参与者表示有兴趣学习这些技巧。因疼痛导致活动受限天数增加与更高的参与意愿之间存在中等程度的相关性。共确定了17个独特的障碍;每人报告的运动障碍平均数量为2.9±1.8个,放松障碍平均数量为2.2±1.4个。参与这两个项目常见的障碍包括时间冲突、交通、对治疗效果的担忧以及对疼痛或受伤的恐惧。

结论

患有慢性疼痛的老年初级护理患者愿意尝试运动和放松疗法来帮助管理疼痛,但报告参与这些项目存在大量障碍。解决患者层面的障碍可以提高老年人参与和坚持运动及放松疗法以管理疼痛的程度。

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