Institute of Health Policy, Management & Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
Geriatric Research Education and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, 98108, USA.
Osteoporos Int. 2018 May;29(5):1093-1104. doi: 10.1007/s00198-018-4399-7. Epub 2018 Feb 17.
Little is known about long-term pain after a fragility fracture. In this secondary analysis, we determined that pain continues to influence many patients' lives more than 1 year after a fracture and that health care providers do not seem to adequately recognize or manage these long-term consequences.
We characterized perspectives on long-term pain among men and women who had sustained a fragility fracture.
We conducted a secondary analysis of qualitative data from 67 individuals recruited in three primary studies (47-89 years old; 55 women, 12 men). Eligible individuals from the primary studies were those who had reported pain related to their fracture beyond 6 months. Data about reported pain were re-analyzed using qualitative description as articulated by Sandelowski.
Thirty-four individuals (47-89 years old; 4 men; 8 had sustained a vertebral fracture) reported pain related to their fracture in the primary studies. Thirty-one (91%) participants had sustained a fragility fracture at least 1 year previously (range 1-13 years). Patients described long-term pain beyond typical fracture healing times, generally unrelieved by analgesics, which affected their mobility, functional activity, independence, sleep, and energy. Health care providers were perceived to under-estimate timelines regarding the decrease of post-fracture pain and to not manage that pain. Participants reported that pain management was inadequate and that they developed their own strategies to respond to it.
Pain continues to influence many patients' lives more than 1 year after a fragility fracture. Patient narratives could be useful to help health care providers to better recognize and manage this long-term consequence of fractures.
关于脆性骨折后长期疼痛知之甚少。在这项二次分析中,我们发现疼痛在骨折后 1 年以上仍持续影响许多患者的生活,且医护人员似乎并未充分认识到或处理这些长期后果。
我们描述了发生脆性骨折后男性和女性对长期疼痛的看法。
我们对 3 项初级研究中招募的 67 名符合条件的个体(47-89 岁;55 名女性,12 名男性)的定性数据进行了二次分析。初级研究中符合条件的个体是报告骨折后疼痛超过 6 个月的个体。使用桑德洛维奇(Sandelowski)提出的定性描述方法重新分析报告疼痛的数据。
34 名个体(47-89 岁;4 名男性;8 名发生了椎体骨折)在初级研究中报告了与骨折相关的疼痛。31 名(91%)参与者至少在 1 年前发生了脆性骨折(骨折后 1-13 年)。患者描述了超出典型骨折愈合时间的长期疼痛,通常镇痛药无法缓解,这影响了他们的活动能力、功能活动、独立性、睡眠和精力。医护人员被认为低估了骨折后疼痛减轻的时间线,并且没有对疼痛进行管理。参与者报告疼痛管理不足,他们自己制定了应对疼痛的策略。
疼痛在脆性骨折后 1 年以上仍持续影响许多患者的生活。患者的叙述可能有助于帮助医护人员更好地认识和处理骨折的这一长期后果。