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急诊科慢性疼痛管理障碍的定性研究

A qualitative study of the barriers to chronic pain management in the ED.

作者信息

Wilsey Barth L, Fishman Scott M, Crandall Margie, Casamalhuapa Carlos, Bertakis Klea D

机构信息

VA Northern California Health Care System, Sacramento, CA 95655, USA.

出版信息

Am J Emerg Med. 2008 Mar;26(3):255-63. doi: 10.1016/j.ajem.2007.05.005.

Abstract

PURPOSE

This qualitative study sought to identify perceived barriers to diagnosing and treating patients with chronic pain in the emergency department (ED).

BASIC PROCEDURE

Semistructured interviews were conducted with 24 ED physicians from 4 hospitals to elucidate their experiences of managing chronic pain in the ED.

MAIN FINDINGS

Time limitations and a low triage priority were major barriers to caring for patients with chronic pain. But despite the inherent problems of treating a nonurgent condition in a time-limited setting, physicians were strong proponents for treating chronic pain in the ED.

PRINCIPAL CONCLUSION

Acknowledging that pain can neither be verified nor disproved, physicians tend to err on the side of the patient, often providing an allotment of opioid medications. They also believe that the ED is not an optimal setting for treating patients in chronic pain but that it is often the last resort for many of these patients, thus, providing the rationale for serving them to the best of their ability.

摘要

目的

本定性研究旨在确定急诊科诊断和治疗慢性疼痛患者时所察觉到的障碍。

基本程序

对来自4家医院的24名急诊科医生进行了半结构化访谈,以阐明他们在急诊科管理慢性疼痛的经验。

主要发现

时间限制和低分诊优先级是护理慢性疼痛患者的主要障碍。但是,尽管在有限的时间内治疗非紧急情况存在固有问题,医生们仍是在急诊科治疗慢性疼痛的坚定支持者。

主要结论

认识到疼痛既无法证实也无法证伪,医生往往偏向于患者,经常提供一定量的阿片类药物。他们还认为,急诊科并非治疗慢性疼痛患者的最佳场所,但对许多此类患者来说,这里往往是最后的求助之地,因此,这为尽最大能力为他们提供治疗提供了理由。

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