慢性肌肉骨骼疼痛的自我护理——患者及医护人员的经历与态度
Self-care of chronic musculoskeletal pain - experiences and attitudes of patients and health care providers.
作者信息
Kovačević Irena, Kogler Višnja Majerić, Turković Tihana Magdić, Dunkić Lidija Fumić, Ivanec Željko, Petek Davorina
机构信息
University of Applied Health Sciences, Mlinarska 38, 10 000, Zagreb, Croatia.
School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia.
出版信息
BMC Musculoskelet Disord. 2018 Mar 7;19(1):76. doi: 10.1186/s12891-018-1997-7.
BACKGROUND
Self-care is often the first choice for people with chronic musculoskeletal pain. Self-care includes the use of non-prescription medications with no doctor's supervision, as well as the use of other modern and traditional treatment methods with no consultation of the health care provider. Self-care may have positive effects on the successful outcome of a multidisciplinary approach to treatment. The aim of this study was to investigate the experiences and attitudes of patients and health care providers to the self-care of chronic musculoskeletal pain.
METHODS
Qualitative Phenomenological study, where the data were collected by the method of an audio-taped interview in 15 patients at the outpatient clinic for pain management and in 20 health care providers involved in the treatment of those patients. The interviews were transcribed verbatim and analyzed by principles of Interpretative Thematic Analysis.
RESULTS
Topics identified in patients: a) positive aspects of self-care, b) a need for pain self-care, c) social aspects of pain self-care. Topics identified in health care providers: a) aspects of self-care, b) a need for self-care c) risks of self-care. Most of patients have positive attitude to self-care and this is the first step to pain management and to care for itself. The most frequent factors influencing decision about the self-care are heavy pain, unavailability of the doctor, long awaiting time for the therapy, or ineffectiveness of methods of conventional medicine. The health care providers believe that self-care of chronic musculoskeletal pain may be a patient's contribution to clinical treatment. However, good awareness of methods used is important in this context, to avoid adverse effects of self-care.
CONCLUSION
Patients understand the self-care of musculoskeletal pain as an individually adjusted treatment and believe in its effectiveness. Health care providers support self-care as an adjunction to clinical management only, and think that self-care of musculoskeletal pain acts as a placebo, with a short-lived effect on chronic musculoskeletal pain.
背景
自我护理通常是慢性肌肉骨骼疼痛患者的首选。自我护理包括在没有医生监督的情况下使用非处方药，以及在没有咨询医疗服务提供者的情况下使用其他现代和传统治疗方法。自我护理可能对多学科治疗方法的成功结果产生积极影响。本研究的目的是调查患者和医疗服务提供者对慢性肌肉骨骼疼痛自我护理的体验和态度。
方法
定性现象学研究，通过对15名在疼痛管理门诊就诊的患者以及参与这些患者治疗的20名医疗服务提供者进行录音访谈来收集数据。访谈内容逐字转录，并根据解释性主题分析原则进行分析。
结果
患者中确定的主题：a）自我护理的积极方面，b）疼痛自我护理的必要性，c）疼痛自我护理的社会方面。医疗服务提供者中确定的主题：a）自我护理的方面，b）自我护理的必要性，c）自我护理的风险。大多数患者对自我护理持积极态度，这是疼痛管理和自我护理的第一步。影响自我护理决策的最常见因素是剧痛、无法看医生、治疗等待时间长或传统医学方法无效。医疗服务提供者认为，慢性肌肉骨骼疼痛的自我护理可能是患者对临床治疗的贡献。然而，在这种情况下，对所使用方法的良好认知很重要，以避免自我护理的不良影响。
结论
患者将肌肉骨骼疼痛的自我护理理解为一种个性化调整的治疗方法，并相信其有效性。医疗服务提供者仅支持将自我护理作为临床管理的辅助手段，并认为肌肉骨骼疼痛的自我护理起到安慰剂的作用，对慢性肌肉骨骼疼痛的影响短暂。
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