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加拿大儿童专用多学科疼痛管理中心:现状

Dedicated multidisciplinary pain management centres for children in Canada: the current status.

作者信息

Peng Philip, Stinson Jennifer N, Choiniere Manon, Dion Dominique, Intrater Howard, Lefort Sandra, Lynch Mary, Ong May, Rashiq Saifee, Tkachuk Gregg, Veillette Yves

机构信息

Wasser Pain Management Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ontario.

出版信息

Can J Anaesth. 2007 Dec;54(12):985-91. doi: 10.1007/BF03016632.

Abstract

PURPOSE

The objective of this study was to examine the services currently offered by multidisciplinary pain treatment facilities (MPTFs) dedicated for pediatric chronic pain management across Canada.

METHODS

A MPTF was defined as a clinic that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain and had a minimum of three different health care disciplines (including at least one medical speciality) available and integrated within the facility. The search method was previously described in an accompanying article. Designated investigators were responsible for confirming and supplementing MPTFs from the preliminary list in their respective provinces. Administrative leads at each eligible MPTF were asked to complete a detailed questionnaire on their infrastructure, clinical, research, teaching and administrative activities. Only MPTFs dedicated to pediatric populations were included.

RESULTS

Only five centres surveyed had dedicated pediatric MPTFs, all located in major cities in five different provinces. While the median wait time was four weeks, it could be as long as nine months in one MPTF. Headache and neuropathic pain were the most commonly treated pain syndromes. All MPTFs included physicians, nurses and psychologists, and used a rehabilitation model that incorporated a wide variety of pharmacological, psychological and physical therapies. All centres provided training for medical and other healthcare professionals, and three of the five centres conducted research. Government funding was the major source of funding for patient services and overhead costs.

CONCLUSIONS

There are very few pediatric MPTFs in Canada. These facilities exist in five of ten provinces, each within large urban centres. Limited accessibility leads to variable and prolonged wait times for pediatric patients suffering from chronic pain.

摘要

目的

本研究的目的是调查加拿大各地专门用于小儿慢性疼痛管理的多学科疼痛治疗机构(MPTF)目前提供的服务。

方法

MPTF被定义为一家诊所,该诊所宣传提供专门的多学科服务,用于慢性疼痛的诊断和管理,并且在机构内至少有三种不同的医疗保健学科(包括至少一个医学专科)可供使用并整合在一起。搜索方法先前已在一篇配套文章中描述。指定的研究人员负责确认和补充各自省份初步名单中的MPTF。要求每个符合条件的MPTF的行政负责人填写一份关于其基础设施、临床、研究、教学和行政活动的详细问卷。仅纳入专门针对儿科人群的MPTF。

结果

接受调查的只有五个中心设有专门的儿科MPTF,均位于五个不同省份的主要城市。虽然中位等待时间为四周,但在一个MPTF中可能长达九个月。头痛和神经性疼痛是最常治疗的疼痛综合征。所有MPTF都包括医生、护士和心理学家,并采用了一种康复模式,该模式纳入了多种药物、心理和物理疗法。所有中心都为医学和其他医疗保健专业人员提供培训,五个中心中有三个进行研究。政府资金是患者服务和间接费用的主要资金来源。

结论

加拿大的儿科MPTF非常少。这些机构存在于十个省份中的五个,每个都位于大型城市中心。可及性有限导致患有慢性疼痛的儿科患者等待时间长短不一且延长。

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