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[创伤难民中的慢性疼痛]

[Chronic pain in traumatized refugees].

作者信息

Dahl Solveig, Dahl Carl-Ivar, Sandvik Leiv, Hauff Edvard

机构信息

Avdeling for forskning og undervisning, Psykiatrisk divisjon, Ullevål universitetssykehus 0407 Oslo.

出版信息

Tidsskr Nor Laegeforen. 2006 Feb 23;126(5):608-10.

Abstract

BACKGROUND

The purpose of this article is to describe the prevalence of chronic pain in traumatized refugees. Further, we sought to identify the possible associations between pain and psychosocial factors, reported traumatic events, and posttraumatic stress disorder.

MATERIALS AND METHODS

Seventy-two patients (40%) were followed up 3 to 8 years after contact with a psychiatric outpatient clinic at the Psychosocial Centre for Refugees in the University of Oslo. Of the men, 83 % had been imprisoned before flight, of the women, 44%. In this study data was collected at onset of treatment and at follow up by a semi-structured interview. We included data on pain, previously experienced traumatic events, socio-demographic information, social support and psychiatric symptoms using the Hopkins symptom check list-25, the symptom scale of Harvard trauma questionnaire, and a screening for a diagnosis of posttraumatic stress disorder according to the DSM-IV. Additionally, general assessment of functioning was estimated. Chronic pain was defined as suffering continuously from serious pain over the last 6 months.

RESULTS AND INTERPRETATION

Forty-seven (65%) patients reported they had problems with chronic pain; out of these, 34 (72%) reported they experienced severe pain. No significant association was found between type or number of traumatic event and chronic pain. Significant association was found between severe chronic pain, posttraumatic stress disorder, anxiety and depression scores, general assessment of functioning, and medium/low social support. A significant association was found between severe chronic pain and the frequency of consultations with a general practitioner. Inquiry about and treatment for chronic severe pain should be included in the rehabilitation of traumatized refugees.

摘要

背景

本文旨在描述受创伤难民中慢性疼痛的患病率。此外,我们试图确定疼痛与心理社会因素、报告的创伤事件和创伤后应激障碍之间可能存在的关联。

材料与方法

72名患者(占40%)在与奥斯陆大学难民心理社会中心的精神科门诊接触3至8年后接受了随访。男性中,83%在逃亡前曾被监禁,女性中这一比例为44%。在本研究中,数据是在治疗开始时和随访时通过半结构化访谈收集的。我们纳入了有关疼痛、既往经历的创伤事件、社会人口学信息、社会支持以及使用霍普金斯症状清单-25、哈佛创伤问卷症状量表和根据《精神疾病诊断与统计手册》第四版进行的创伤后应激障碍诊断筛查得出的精神症状的数据。此外,还对功能进行了总体评估。慢性疼痛定义为在过去6个月中持续遭受严重疼痛。

结果与解读

47名(65%)患者报告他们有慢性疼痛问题;其中,34名(72%)报告他们经历了严重疼痛。未发现创伤事件的类型或数量与慢性疼痛之间存在显著关联。发现严重慢性疼痛、创伤后应激障碍、焦虑和抑郁评分、功能总体评估以及中等/低社会支持之间存在显著关联。发现严重慢性疼痛与全科医生会诊频率之间存在显著关联。对受创伤难民的康复应包括对慢性严重疼痛的询问和治疗。

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