Chen Eric, Tsoy Daniel, Upadhye Suneel, Chan Teresa M
Faculty of Health Sciences, Department of Medicine, Division of Emergency Medicine, McMaster University.
Cureus. 2018 Mar 30;10(3):e2399. doi: 10.7759/cureus.2399.
Introduction The diagnosis of chronic pain involves symptoms of pain of various etiologies lasting longer than six months. The prevalence of chronic pain in society ranges from 19% to 31% in North America. While chronic pain patient perceptions on the care provided to them in the Emergency Department (ED) have been studied, there has not been significant attention given to the attitudes of acute care providers towards these patients. Methods We utilized online questionnaires disseminated on Twitter, Facebook, Reddit, and emergency medicine blogs to gauge care provider attitudes of chronic pain patients. Survey respondents included ED physicians and their trainees, ED nurses and nurse practitioners, paramedics, and physician assistants. Results Responses revealed numerous factors impacting care provider dissatisfaction with treating chronic pain in the ED; significant factors included the lack of longitudinal care and inappropriate medication of chronic pain resulting in dependency. We found that additional chronic pain-specific training was associated with increased care provider confidence in the treatment of chronic pain. Practice patterns were found to be varied, with half of the respondents stating that chronic pain should be medicated acutely. Conclusions We conclude that acute care provider dissatisfaction with chronic pain treatment is multifactorial in origin and that confidence in the acute treatment of chronic pain can be improved with chronic pain-specific training.
引言 慢性疼痛的诊断涉及各种病因引起的疼痛症状持续超过六个月。在北美,社会中慢性疼痛的患病率在19%至31%之间。虽然已经研究了慢性疼痛患者对急诊科(ED)提供给他们的护理的看法,但急性护理提供者对这些患者的态度尚未得到足够重视。方法 我们利用在推特、脸书、红迪网和急诊医学博客上发布的在线问卷来评估护理提供者对慢性疼痛患者的态度。调查对象包括急诊科医生及其实习生、急诊科护士和执业护士、护理人员以及医师助理。结果 调查结果显示了影响护理提供者对在急诊科治疗慢性疼痛不满的诸多因素;重要因素包括缺乏长期护理以及慢性疼痛用药不当导致成瘾。我们发现,额外的慢性疼痛专项培训与护理提供者对慢性疼痛治疗的信心增强有关。发现实践模式各不相同,一半的受访者表示慢性疼痛应进行急性药物治疗。结论 我们得出结论,急性护理提供者对慢性疼痛治疗的不满源于多方面因素,并且通过慢性疼痛专项培训可以提高对慢性疼痛急性治疗的信心。