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患有慢性疼痛并接受阿片类药物治疗疼痛的人群的初级保健经历:一种定性研究方法。

Primary care experiences of people who live with chronic pain and receive opioids to manage pain: A qualitative methodology.

作者信息

St Marie Barbara

机构信息

College of Nursing, The University of Iowa, Iowa City, Iowa.

出版信息

J Am Assoc Nurse Pract. 2016 Aug;28(8):429-35. doi: 10.1002/2327-6924.12342. Epub 2016 Jan 22.

Abstract

BACKGROUND AND PURPOSE

The prevalence of chronic pain continues to rise and the majority of patients with chronic pain are managed in primary care. The purpose of this research was to provide the perspectives of patients who live with chronic pain and receive opioids to help manage their pain from primary care.

METHODS

In this qualitative study, 12 participants from a Midwest primary care clinic described their primary care experiences with receiving opioids for chronic pain. Thematic and interpretive analyses were used to understand the issues.

CONCLUSIONS

Participants receiving opioids for pain management through primary care feared losing access to opioids, wanted to protect sobriety when they had histories of substance use disorder, experienced stress at their jobs with frequent appointments, identified inconsistencies in health care prolonging their suffering and increasing substance misuse, and identified improvement in coping with pain when they had confidence in healthcare providers.

IMPLICATIONS FOR PRACTICE

Providing patient-centered care while managing patients with pain and unknown risk for prescription opioid misuse is possible. Understanding influences that create prescription opioid risk for misuse can help nurse practitioners improve their delivery of care by providing consistent and convenient healthcare encounters, and help patients protect themselves from risk of prescription opioid misuse.

摘要

背景与目的

慢性疼痛的患病率持续上升,大多数慢性疼痛患者在初级保健机构接受治疗。本研究的目的是了解慢性疼痛患者接受阿片类药物以缓解疼痛的初级保健体验。

方法

在这项定性研究中,来自中西部一家初级保健诊所的12名参与者描述了他们在接受阿片类药物治疗慢性疼痛方面的初级保健经历。采用主题分析和解释性分析来理解这些问题。

结论

通过初级保健接受阿片类药物治疗疼痛的参与者担心无法继续获得阿片类药物,有物质使用障碍病史的人希望保持清醒,因频繁预约而在工作中感到压力,发现医疗保健中的不一致延长了他们的痛苦并增加了物质滥用,并且当他们对医疗保健提供者有信心时,应对疼痛的能力有所改善。

实践意义

在管理有疼痛且存在处方阿片类药物滥用未知风险的患者时,提供以患者为中心的护理是可行的。了解造成处方阿片类药物滥用风险的影响因素,有助于执业护士通过提供一致且便捷的医疗服务来改善护理,并帮助患者保护自己免受处方阿片类药物滥用的风险。

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