Wilson Marian, Roll John, Pritchard Patty, Masterson Bat, Howell Donelle, Barbosa-Leiker Celestina
Spokane and Pullman, WA; Coeur d'Alene, ID.
Spokane and Pullman, WA; Coeur d'Alene, ID.
J Emerg Nurs. 2014 May;40(3):e55-61. doi: 10.1016/j.jen.2013.03.011. Epub 2013 Apr 28.
Patients with chronic pain who frequent emergency departments present a challenge to health care providers. Mental health, substance abuse, and pain issues are difficult to distinguish in fast-paced clinical settings, and significant symptoms may remain unaddressed. This pilot study sought to determine whether electronically delivered screening tools measuring pain and mood could identify areas to target for improving emergency care.
A prospective, descriptive pilot study used repeated measures of validated instruments to investigate the status of patients after their ED encounter. Persons with chronic pain not related to cancer and documented opioid use were recruited by nursing personnel after an ED encounter. Consenting participants (n = 52) were invited to perform an online survey that included self-reported measurements of pain intensity, pain interference, depression, subjective health, and health distress. The survey was repeated after 8 weeks.
The baseline survey was completed by 42.3% of 52 patients who provided consent (n = 22, 68.2% female). The mean pain severity score was 5.96 (SD 1.57) and the mean pain interference score was 7.52 (SD 1.81) using 0 to 10 scales of the Brief Pain Inventory. Personal Health Questionnaire Depression Scale ratings indicated that a major depressive disorder should be considered for 54% of the participants.
Online surveys delivered to patients with chronic pain detected unmet needs for depression and persisting high levels of pain interference after ED encounters. Adding mood-specific screening tools to pain assessments may be necessary in clinical settings to identify depression and refer for appropriate treatment.
经常前往急诊科的慢性疼痛患者给医疗服务提供者带来了挑战。在快节奏的临床环境中，心理健康、药物滥用和疼痛问题很难区分，重要症状可能得不到解决。这项初步研究旨在确定电子提供的测量疼痛和情绪的筛查工具是否能够识别出可作为改善急诊护理目标的领域。
一项前瞻性描述性初步研究使用经过验证的工具的重复测量来调查患者在急诊科就诊后的状况。急诊科就诊后，护理人员招募了与癌症无关且有阿片类药物使用记录的慢性疼痛患者。邀请同意参与的参与者（n = 52）进行一项在线调查，其中包括自我报告的疼痛强度、疼痛干扰、抑郁、主观健康和健康困扰测量。8周后重复进行该调查。
52名提供同意的患者中有42.3%（n = 22，68.2%为女性）完成了基线调查。使用简短疼痛问卷0至10分制，平均疼痛严重程度评分为5.96（标准差1.57），平均疼痛干扰评分为7.52（标准差1.81）。个人健康问卷抑郁量表评分表明，54%的参与者应被考虑患有重度抑郁症。
对慢性疼痛患者进行的在线调查发现，他们在急诊科就诊后存在未满足的抑郁需求以及持续高水平的疼痛干扰。在临床环境中，可能有必要在疼痛评估中增加针对情绪的筛查工具，以识别抑郁症并转诊进行适当治疗。
