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慢性非癌性疼痛退伍军人使用补充和替代医学的情况。

Complementary and alternative medicine use among veterans with chronic noncancer pain.

作者信息

Denneson Lauren M, Corson Kathryn, Dobscha Steven K

机构信息

Portland VA Medical Center, PO Box 1034 (P3DEP_PC), Portland, OR 97207, USA.

出版信息

J Rehabil Res Dev. 2011;48(9):1119-28. doi: 10.1682/jrrd.2010.12.0243.

Abstract

We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users were compared with nonusers on demographic characteristics, pain-related clinical characteristics, disease burden, and treatment satisfaction. A majority of veterans ( n = 327, 82%) reported prior use of at least one CAM modality, and nearly all (n = 399, 99%) were willing to try CAM treatment for pain. Chiropractic care was the least preferred option, whereas massage therapy was the most preferred (75% and 96%, respectively). CAM users were less likely to have service-connection disabilities (54% vs 68%; chi square = 4.64, p = 0.03) and reported having spent a larger percentage of their lives in pain (26% vs 20%; Z = 1.40, p = 0.04) than nonusers. We detected few differences between veterans who had tried CAM and those who had not, suggesting that CAM may have broad appeal among veterans with chronic pain. Implications for VA policy and practice and for clinicians treating veterans with chronic pain are discussed.

摘要

我们描述了401名患有慢性非癌性疼痛的退伍军人对补充和替代医学(CAM)的既往使用情况及尝试意愿,并探讨了CAM使用者与非使用者之间的差异。来自五个退伍军人事务部(VA)初级保健诊所的慢性疼痛协作干预随机对照试验的参与者自行报告了对脊椎按摩疗法、按摩治疗、草药和针灸的既往使用情况及尝试意愿。将既往使用CAM的使用者与非使用者在人口统计学特征、疼痛相关临床特征、疾病负担和治疗满意度方面进行了比较。大多数退伍军人(n = 327,82%)报告曾使用过至少一种CAM方式,几乎所有退伍军人(n = 399,99%)都愿意尝试针对疼痛的CAM治疗。脊椎按摩疗法是最不受欢迎的选择,而按摩治疗是最受欢迎的(分别为75%和96%)。与非使用者相比,CAM使用者患与服役相关残疾的可能性较小(54%对68%;卡方 = 4.64,p = 0.03),且报告称一生中处于疼痛状态的时间占比更大(26%对20%;Z = 1.40,p = 0.04)。我们发现尝试过CAM的退伍军人与未尝试过的退伍军人之间几乎没有差异,这表明CAM可能对患有慢性疼痛的退伍军人具有广泛吸引力。本文还讨论了对VA政策和实践以及对治疗患有慢性疼痛退伍军人的临床医生的启示。

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