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医疗服务提供者对小儿镰状细胞病相关疼痛的综合医学观点。

Provider Perspective on Integrative Medicine for Pediatric Sickle Cell Disease-related Pain.

作者信息

Neri Caitlin M, Beeson Tishra, Mead Holly, Darbari Deepika S, Meier Emily Riehm

机构信息

Division of Pediatric Hematology, Boston Medical Center, Massachusetts; Department of Pediatrics, Boston University School of Medicine (Dr Neri), United States.

Department of Physical Education, School & Public Health, Central Washington University, Ellensburg (Dr Beeson), United States.

出版信息

Glob Adv Health Med. 2016 Jan;5(1):44-50. doi: 10.7453/gahmj.2015.101. Epub 2016 Jan 1.

Abstract

OBJECTIVE

Integrative medicine (IM) approaches are sometimes used to manage sickle cell disease (SCD)-related pain. The purpose of this research is to (1) understand provider perspective towards the use of IM for pain in children with SCD at a large urban children's hospital and (2) provide recommendations on how to better promote IM for children and adolescents with SCD.

METHODS

After approval from the institutional review board, a qualitative case study approach was used with criterion-type purposeful sampling to select providers from the division of hematology to adequately inform the study. Semistructured interviews were completed using audiotape to facilitate transcription. NVivo 10 analytic software (QSR International Pty Ltd, Doncaster, Victoria, Australia) was used to organize data into themes to answer the study questions.

RESULTS

Ten provider interviews were completed. Attitudes were generally positive, and most providers felt that IM is generally helpful. All providers reported that they do not optimally use integrative therapies for children with SCD. The barriers uncovered focused on lack of process for integration of IM, specifically that IM resources seem transient and based on short-term funding. Provider attitude towards CAM is generally positive, but provider comfort level is highly variable. No providers are completely comfortable with their knowledge base about IM, and increased knowledge is desired.

CONCLUSIONS

Creation of protocols and processes to incorporate IM into management plans for patients with SCD could help to promote its use. Education of providers about utility and efficacy of IM for SCD-related pain and about existing resources would aid in promotion of IM for children with SCD.

摘要

目的

综合医学方法有时用于管理镰状细胞病(SCD)相关疼痛。本研究的目的是:(1)了解在一家大型城市儿童医院中,医疗服务提供者对于在患有SCD的儿童中使用综合医学治疗疼痛的看法;(2)就如何更好地在患有SCD的儿童和青少年中推广综合医学提供建议。

方法

经机构审查委员会批准后,采用定性案例研究方法,通过标准型目的抽样从血液科挑选医疗服务提供者,以便为研究提供充分信息。使用录音带辅助转录完成半结构化访谈。使用NVivo 10分析软件(QSR国际私人有限公司,澳大利亚维多利亚州唐卡斯特)将数据整理成主题,以回答研究问题。

结果

完成了对10名医疗服务提供者的访谈。态度总体上是积极的,大多数医疗服务提供者认为综合医学总体上有帮助。所有医疗服务提供者都表示,他们没有为患有SCD的儿童最佳地使用综合治疗方法。发现的障碍集中在综合医学整合过程的缺乏,特别是综合医学资源似乎是短暂的且基于短期资金。医疗服务提供者对补充替代医学(CAM)的态度总体上是积极的,但医疗服务提供者的舒适度差异很大。没有医疗服务提供者对其关于综合医学的知识基础完全满意,他们希望增加相关知识。

结论

制定将综合医学纳入SCD患者管理计划的方案和流程,有助于促进其使用。对医疗服务提供者进行关于综合医学对SCD相关疼痛的效用和疗效以及现有资源的教育,将有助于在患有SCD的儿童中推广综合医学。

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Defining the phenotypes of sickle cell disease.定义镰状细胞病的表型。
Hemoglobin. 2011;35(5-6):511-9. doi: 10.3109/03630269.2011.610477. Epub 2011 Sep 20.
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Update on pain management in sickle cell disease.镰状细胞病疼痛管理的最新进展。
Hemoglobin. 2011;35(5-6):520-9. doi: 10.3109/03630269.2011.610478. Epub 2011 Sep 12.
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Population estimates of sickle cell disease in the U.S.美国镰状细胞病的人口估计数
Am J Prev Med. 2010 Apr;38(4 Suppl):S512-21. doi: 10.1016/j.amepre.2009.12.022.

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