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对疼痛管理过程中对个体重要的因素进行的定性调查。

A qualitative investigation of factors that matter to individuals in the pain management process.

作者信息

Franklin Zoe C, Smith Nickolas C, Fowler Neil E

机构信息

a Institute for Performance Research, Manchester Metropolitan University , Crewe , UK.

出版信息

Disabil Rehabil. 2016 Sep;38(19):1934-42. doi: 10.3109/09638288.2015.1107782. Epub 2016 Jan 4.

Abstract

OBJECTIVE

Chronic musculoskeletal pain is a complex condition to manage with widespread consequences including physical disability, psychosocial effects and increased use of healthcare. Previous research has found patients' experiences within health care can be influenced by factors such as expectations, therapist characteristics and treatment process. This study used patient interviews to identify the key factors that influence individuals' experiences in the management of chronic pain.

DESIGN

Qualitative study using semi-structured interviews in either a home or hospital setting.

METHODS

Semi-structured interviews were conducted on eight participants attending hospital-based pain management. Participants were asked about their experiences of pain management and living with a chronic pain condition. Interviews were transcribed and analysed thematically.

RESULTS

Three main themes were identified; impact of their condition on daily life, clinical interactions and the pain management process. Understanding the condition was a key factor for the patients, in particular, explanation by the clinician. The temporality of their pain meant timing of appointments was critical. Patients reported factors such as family days and follow-up sessions would improve their treatment experience.

CONCLUSIONS

This study highlighted important factors for healthcare professionals and patients in the management of chronic pain. Participants indicated a desire to understand their condition and learn strategies for self-management to allow them to cope better. As patients found benefit from being involved in the management process, discussions around the options for treatment may enhance management and rehabilitation. It is important we continue to research factors important to individuals with musculoskeletal pain to find an effective, evidence-based framework for understanding and managing this condition. Implications for rehabilitation This study highlights the importance to patients of being given information to help them understand their pain condition and to learn strategies for self-management to cope better. Where information was not provided and inadequate time allowed for questioning and discussion, patients tended to desire more frequent access to the care services. More effective communication may result in reduced demand and more efficient management. Patients suggested that ongoing peer support may offer an alternative to clinician-led services.

摘要

目的

慢性肌肉骨骼疼痛是一种难以管理的复杂病症,会产生广泛的后果,包括身体残疾、心理社会影响以及医疗保健使用增加。先前的研究发现,患者在医疗保健中的体验可能会受到期望、治疗师特征和治疗过程等因素的影响。本研究通过患者访谈来确定影响个体慢性疼痛管理体验的关键因素。

设计

采用定性研究方法,在家庭或医院环境中进行半结构化访谈。

方法

对八名参加医院疼痛管理的参与者进行了半结构化访谈。询问参与者有关疼痛管理的经历以及患有慢性疼痛病症的生活情况。访谈进行了转录并进行了主题分析。

结果

确定了三个主要主题;病情对日常生活的影响、临床互动以及疼痛管理过程。了解病情是患者的关键因素,特别是临床医生的解释。疼痛的时效性意味着预约时间至关重要。患者报告说,家庭日和随访等因素会改善他们的治疗体验。

结论

本研究突出了医疗保健专业人员和患者在慢性疼痛管理中的重要因素。参与者表示希望了解自己的病情并学习自我管理策略,以便更好地应对。由于患者发现参与管理过程有益,围绕治疗选择的讨论可能会加强管理和康复。我们继续研究对肌肉骨骼疼痛患者重要的因素,以找到一个有效、基于证据的框架来理解和管理这种病症,这一点很重要。对康复的启示 本研究强调了向患者提供信息以帮助他们了解疼痛状况并学习自我管理策略以更好地应对的重要性。在没有提供信息且没有足够时间进行提问和讨论的情况下,患者往往希望更频繁地获得护理服务。更有效的沟通可能会减少需求并提高管理效率。患者建议持续的同伴支持可能是临床医生主导服务的一种替代方式。

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