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中国骨关节炎老年人的疼痛体验、控制信念和应对策略

Pain experiences, control beliefs and coping strategies in Chinese elders with osteoarthritis.

作者信息

Tsai Yun-Fang, Chu Tsung-Lan, Lai Yeur-Hur, Chen Wen-Jen

机构信息

School of Nursing, Chang Gung University and Department of Nursing, Chang Gung Memorial Hospital, Taiwan.

出版信息

J Clin Nurs. 2008 Oct;17(19):2596-603. doi: 10.1111/j.1365-2702.2008.02306.x.

Abstract

AIM

To explore pain experiences, pain control beliefs and pain coping strategies among elders with osteoarthritis in Taiwan.

BACKGROUND

Osteoarthritis, a degenerative disease that commonly affects older people, is manifested by pain and disability. Despite the increasing number of older people, few studies have explored their chronic pain experiences, pain beliefs and pain coping strategies.

DESIGN

Survey.

METHODS

Participants (n = 205) were recruited by convenience sampling from three outpatient clinics at a medical centre in northern Taiwan. Data were collected by questionnaire on pain sites, pain intensity, pain interference with activity, pain control beliefs, pain coping strategies, depressive tendency and demographic variables. Scores of worst pain intensity were used to divide participants into three groups: mild, moderate and severe pain.

RESULTS

Participants' average number of pain sites was 2.9 (SD 2.2). Most participants (70%) suffered moderate to severe worst pain. Participants perceived average pain control beliefs (mean 1.7, SD 0.7). Most used pharmacological coping strategies about half of the time (mean 1.8, SD 0.7) and non-pharmacological coping strategies about one-quarter of the time (mean 1.0, SD 0.5). Scores on satisfaction with living situation, depressive tendency, pain intensity, pain interference, pain control beliefs and frequency of using pharmacological coping strategies differed significantly among the three pain groups. Results of regression analysis showed that the intensity of average pain, pain interference with walking, pain interference with sleeping and pain control beliefs significantly predicted intensity of worst pain, explaining 54% of the variance in intensity of worst pain.

CONCLUSION

This study highlights the importance of dealing with pain in this population.

RELEVANCE TO CLINICAL PRACTICE

Since health care providers play an important role in helping elders to manage pain, the authors recommend training physicians and nurses to regularly assess pain and to provide current knowledge about pain assessment and management strategies for elders with osteoarthritis.

摘要

目的

探讨台湾地区骨关节炎老年人的疼痛经历、疼痛控制信念及疼痛应对策略。

背景

骨关节炎是一种常见于老年人的退行性疾病,表现为疼痛和残疾。尽管老年人数量不断增加,但很少有研究探讨他们的慢性疼痛经历、疼痛信念及疼痛应对策略。

设计

调查研究。

方法

采用便利抽样法,从台湾北部某医疗中心的三家门诊诊所招募了205名参与者。通过问卷调查收集有关疼痛部位、疼痛强度、疼痛对活动的干扰、疼痛控制信念、疼痛应对策略、抑郁倾向和人口统计学变量的数据。使用最严重疼痛强度评分将参与者分为三组:轻度、中度和重度疼痛。

结果

参与者的平均疼痛部位数为2.9个(标准差为2.2)。大多数参与者(70%)经历了中度至重度的最严重疼痛。参与者对疼痛控制信念的平均感知得分为1.7(标准差为0.7)。大多数人大约一半时间采用药物应对策略(平均分为1.8,标准差为0.7),约四分之一时间采用非药物应对策略(平均分为1.0,标准差为0.5)。三组疼痛患者在生活状况满意度、抑郁倾向、疼痛强度、疼痛干扰、疼痛控制信念及使用药物应对策略的频率方面得分差异显著。回归分析结果显示,平均疼痛强度、疼痛对行走的干扰、疼痛对睡眠的干扰及疼痛控制信念显著预测了最严重疼痛的强度,解释了最严重疼痛强度变异的54%。

结论

本研究强调了应对该人群疼痛问题的重要性。

与临床实践的相关性

由于医疗保健提供者在帮助老年人管理疼痛方面发挥着重要作用,作者建议培训医生和护士定期评估疼痛,并为骨关节炎老年人提供有关疼痛评估和管理策略的最新知识。

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