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关节炎中老年患者的疼痛体验和自我管理策略。

Pain experiences and self-management strategies among middle-aged and older adults with arthritis.

机构信息

School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

J Clin Nurs. 2013 Jul;22(13-14):1857-69. doi: 10.1111/jocn.12134. Epub 2013 Mar 27.

Abstract

AIMS AND OBJECTIVES

The purposes were (1) to explore pain experiences and the use and perceived effectiveness of pain self-management methods among middle-aged and older adults with osteoarthritis or rheumatoid arthritis in mainland China and (2) to compare those with diagnoses of osteoarthritis and rheumatoid arthritis.

BACKGROUND

Prior research has suggested that pain is a major concern for people with arthritis. However, studies systematically investigating pain experiences and self-management status of arthritis patients are scarce in mainland China.

DESIGN

Descriptive survey.

METHODS

Participants (n = 197) aged 45 and over, diagnosed with either osteoarthritis or rheumatoid arthritis, and experiencing persistent pain were administered three self-report questionnaires: the Demographic Data Questionnaire, the Brief Pain Inventory and the Pain Management Inventory.

RESULTS

The mean of the overall pain intensity was 5.6 (SD = 1.3). The median of number of pain sites was 7.0 (QR = 7.0) and the overall pain interference was 6.0 (QR = 2.6). Most participants experienced moderate to severe pain and interference. The current methods used for managing pain were perceived as only moderately effective. The sample used a median of 4.0 (QR = 3.0) self-management methods. Most often used were prescribed medicine, massage, heat and activity pacing. Methods perceived as most helpful included prescribed medicine, over-the-counter medicine, hot baths and heat. Persons with rheumatoid arthritis had significantly more pain sites, higher pain intensity and greater number of pain management methods used compared to those with osteoarthritis.

CONCLUSIONS

Pain management is a significant problem in this population. The findings highlight the importance of helping the individual to identify and appropriately use a variety of self-management methods, selecting the appropriate method(s) at any one time.

RELEVANCE TO CLINICAL PRACTICE

Healthcare providers are urged to develop appropriate interventions on pain management tailored to arthritis patients in mainland China.

摘要

目的

(1)探索中国内地中老年骨关节炎或类风湿关节炎患者的疼痛体验以及疼痛自我管理方法的使用和感知效果;(2)比较患有骨关节炎和类风湿关节炎的患者。

背景

先前的研究表明,疼痛是关节炎患者的主要关注点。然而,在中国内地,系统研究关节炎患者疼痛体验和自我管理状况的研究很少。

设计

描述性调查。

方法

对 197 名年龄在 45 岁及以上、被诊断为骨关节炎或类风湿关节炎且持续疼痛的患者进行了三项自我报告问卷的调查:人口统计学数据问卷、简明疼痛量表和疼痛管理量表。

结果

总体疼痛强度的平均值为 5.6(SD=1.3)。疼痛部位中位数为 7.0(QR=7.0),总体疼痛干扰中位数为 6.0(QR=2.6)。大多数参与者经历了中度到重度疼痛和干扰。目前用于管理疼痛的方法被认为只是中等有效。该样本使用了 4.0(QR=3.0)种自我管理方法的中位数。最常使用的是处方药、按摩、热疗和活动节奏。被认为最有帮助的方法包括处方药、非处方药、热水浴和热疗。与骨关节炎患者相比,类风湿关节炎患者的疼痛部位更多、疼痛强度更高、使用的疼痛管理方法更多。

结论

在该人群中,疼痛管理是一个重大问题。这些发现强调了帮助个体识别和适当使用各种自我管理方法的重要性,在任何时候都选择适当的方法。

临床相关性

敦促医疗保健提供者为中国内地的关节炎患者制定针对疼痛管理的适当干预措施。

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