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全科医学中颈痛的体验和管理:患者视角。

The experience and management of neck pain in general practice: the patients' perspective.

机构信息

Department of General Practice, University of Göttingen, Göttingen, Germany.

出版信息

Eur Spine J. 2010 Jun;19(6):963-71. doi: 10.1007/s00586-010-1297-x. Epub 2010 Feb 12.

Abstract

The objective of this study is to investigate the perspective and expectation of patients presenting with neck pain in general practice. The study design is a qualitative analysis of patient interviews and was conducted in a primary care setting in Germany. Twenty patients aged 20-78, according to theoretical sampling were included in the study. Patients tried to cope autonomously with the situation and consulted GPs only if their self-help had failed. When patients asked for external help, they usually focused on somatic treatment options such as massage, physiotherapy or injections. Most patients reported to have experiences with somatic therapies; however, they felt that some or all of these treatments were inefficient or led only to short-time improvements. Patients often avoided psychosocial themes when talking to doctors for fear of being branded as 'neurotic'. Although neck pain is difficult to manage and a burden for patients, they have obviously found a way of both living with their pain and a pragmatic approach of talking about their symptoms with their doctor. According to the patients' statements, the interaction between doctor and patient seems to be rather distant, ensuring that both sides avoid any issues that might touch upon psychological aspects of neck pain.

摘要

本研究旨在探讨综合诊所中颈痛患者的观点和期望。该研究设计是对患者访谈的定性分析,并在德国的初级保健环境中进行。根据理论抽样,共有 20 名年龄在 20-78 岁的患者纳入研究。患者试图自主应对这种情况,只有在自助失败的情况下才会咨询全科医生。当患者寻求外部帮助时,他们通常侧重于按摩、物理疗法或注射等躯体治疗选择。大多数患者报告有过躯体治疗的经历;然而,他们觉得这些治疗有些或全部无效,或仅能短暂改善病情。患者在与医生交谈时常常避免涉及心理社会主题,因为他们担心被贴上“神经质”的标签。尽管颈痛难以治疗且给患者带来负担,但他们显然已经找到了一种既能忍受疼痛又能与医生务实讨论症状的方法。根据患者的陈述,医患之间的互动似乎相当疏远,确保双方都避免任何可能涉及颈痛心理方面的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fe6/2899974/304eb676721b/586_2010_1297_Fig1_HTML.jpg

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