Lestoquoy Anna Sophia, Laird Lance D, Mitchell Suzanne, Gergen-Barnett Katherine, Negash N Lily, McCue Kelly, Enad Racquel, Gardiner Paula
Department of Family Medicine, Boston Medical Center, Dowling 5 South, 1 Boston Medical Center Place, Boston, MA 02118, USA.
Department of Family Medicine, Boston Medical Center, Dowling 5 South, 1 Boston Medical Center Place, Boston, MA 02118, USA; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA.
Complement Ther Med. 2017 Dec;35:33-38. doi: 10.1016/j.ctim.2017.09.002. Epub 2017 Sep 12.
Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care.
Six IMGVs cohorts were held at a safety net hospital and two federally funded community health centres. Data was gathered through focus groups. Transcripts were analysed using both a priori codes and inductive coding.
The intervention included ten sessions of Integrative Medical Group Visits with a primary care provider and a meditation instructor. The curriculum uses principles of Mindfulness Based Stress Reduction and evidence based integrative medicine. The visit is structured similarly to other group medical visits.
Data was gathered through four focus groups held after the cohorts were completed.
Participants (N=20) were largely low income minority adults with chronic pain and comorbid depression. Six themes emerged from the coding including: chronic pain is isolating; group treatment contributes to better coping with pain; loss of control and autonomy because of the unpredictability of pain as well as dependence on medication and frequent medical appointments; groups improve agency and control over one's health condition; navigating the healthcare system and unsatisfactory treatment options; and changes after the IMGV due to non-pharmacological health management.
The IMGV is a promising format of delivering integrative care for chronic pain and depression which addresses many of the problems identified by patients in usual care.
对于向低收入、种族多样的慢性疼痛和抑郁症患者提供非药物治疗组策略的接受情况，人们了解甚少。本文探讨综合医疗小组就诊（IMGV）如何解决常规护理中发现的许多不足之处。
在一家安全网医院和两家联邦资助的社区健康中心开展了六个IMGV队列研究。通过焦点小组收集数据。使用先验编码和归纳编码对转录本进行分析。
干预包括与初级保健提供者和冥想指导者进行十次综合医疗小组就诊。课程采用基于正念减压的原则和循证综合医学。就诊的结构与其他小组医疗就诊类似。
在队列研究完成后，通过四个焦点小组收集数据。
参与者（N = 20）主要是患有慢性疼痛和合并抑郁症的低收入少数族裔成年人。编码后出现了六个主题，包括：慢性疼痛使人孤立；小组治疗有助于更好地应对疼痛；由于疼痛的不可预测性以及对药物和频繁医疗预约的依赖而导致失去控制和自主性；小组改善了对自身健康状况的掌控能力；在医疗系统中周旋以及不满意的治疗选择；以及由于非药物健康管理，IMGV后发生的变化。
IMGV是一种为慢性疼痛和抑郁症提供综合护理的有前景的形式，它解决了患者在常规护理中发现的许多问题。
