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我们所说的“老年人持续性疼痛自我管理”是什么意思?一个概念分析。

What do we mean by "older adults' persistent pain self-management"? A concept analysis.

机构信息

Academic Primary Care, University of Aberdeen, Aberdeen, UK.

出版信息

Pain Med. 2014 Feb;15(2):214-24. doi: 10.1111/pme.12251. Epub 2013 Oct 9.

Abstract

BACKGROUND

No standard definition exists for the concept "persistent pain self-management" or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting and can hinder research through difficulties identifying or measuring the concept.

OBJECTIVE

To ascertain attributes, referents, antecedents, and consequences of the concept older adults' persistent pain self-management and develop a theoretical definition.

DESIGN

Rodgers evolutionary model of concept analysis was used to systematically analyze articles from the academic and grey literature (N = 45). Data were extracted using standardized extraction forms and analyzed using thematic analysis.

FINDINGS

This concept was discussed in three ways: as an intervention, in reference to everyday behaviors, and as an outcome. Five defining attributes were identified: multidimensional process, personal development, active individuals, symptom response, and symptom control. Patients' perceived need and ability to manage pain with support from others is necessary for pain self-management to occur. Numerous physical, psychological, and social health consequences were identified. A theoretical definition is discussed.

CONCLUSIONS

Our findings have clarified existing use and understanding regarding the concept of older adults' persistent pain self-management. We have identified three areas for future development: refinement of the attributes of this concept within the context of older adults, an exploration of how providers can overcome difficulties supporting older adults' persistent pain self-management, and a clarification of the overall theoretical framework of older adults' persistent pain self-management.

摘要

背景

目前尚不存在“持续性疼痛自我管理”这一概念的标准定义,也没有明确界定该概念与老年人之间的关系。如果概念定义不明确,可能会导致临床实践中的误解,也会因为难以识别或测量该概念,而阻碍研究的开展。

目的

明确老年人持续性疼痛自我管理这一概念的属性、参照、前因和后果,并对其进行理论定义。

设计

采用 Rodgers 进化式概念分析模型,对学术和灰色文献中的文章(N=45)进行系统分析。使用标准化的提取表格提取数据,并采用主题分析法进行分析。

发现

该概念主要以三种方式进行讨论:作为干预措施、日常行为的参考以及结果。确定了 5 个定义属性:多维过程、个人发展、积极个体、症状反应和症状控制。患者在他人支持下管理疼痛的感知需求和能力是疼痛自我管理发生的必要条件。确定了许多身体、心理和社会健康的后果。并讨论了一个理论定义。

结论

本研究结果阐明了老年人持续性疼痛自我管理这一概念的现有用法和理解。我们确定了未来发展的三个方向:在老年人的背景下进一步细化这一概念的属性、探索提供者如何克服支持老年人持续性疼痛自我管理的困难,以及阐明老年人持续性疼痛自我管理的整体理论框架。

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