Walker Sarah, Hopman Wilma M, Carley Meg E, Mann Elizabeth G, VanDenKerkhof Elizabeth G
School of Nursing and Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada K7L 3N6.
Clinical Research Centre, Kingston General Hospital, Kingston, ON, Canada K7L 2V7; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada K7L 3N6.
Pain Res Manag. 2016;2016:1343568. doi: 10.1155/2016/1343568. Epub 2016 Mar 29.
Background. Pain while waiting for surgery may increase healthcare utilization (HCU) preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n = 360) reported a total of 2026 healthcare visits, with 21% (n = 126) reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10) pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic) compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30) and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.
背景。等待手术期间的疼痛可能会增加术前的医疗服务利用(HCU)。目的。研究妇科手术前一年术前疼痛与医疗服务利用之间的关联。方法。在加拿大一家三级护理中心,对590名等待手术的女性进行了调查,询问她们在手术前一年的医疗服务利用情况。使用简明疼痛量表评估疼痛。结果。33%的女性报告在手术前一周有中度至重度疼痛及疼痛干扰。61%(n = 360)的女性报告总共进行了2026次医疗就诊,其中21%(n = 126)的女性报告在手术前一年就诊6次或更多次。在控制协变量后,与无疼痛或轻度疼痛的女性相比,中度至重度(>3/10)疼痛强度/疼痛干扰的女性报告总体医疗服务利用(过去一年因疼痛相关问题就诊家庭医生或专科医生≥3次或因疼痛相关问题就诊急诊科/无需预约诊所≥1次)的几率更高。较低的体重指数(BMI < 30与≥30)以及焦虑和/或抑郁与急诊科或无需预约诊所就诊相关,但与家庭医生或专科医生就诊无关。结论。等待妇科手术的女性疼痛负担较重。资源分配决策应考虑疼痛对个人和医疗系统的影响。