Smith Crystal Lederhos, Severtsen Billie, Vandermause Roxanne, Barbosa-Leiker Celestina, Wilson Marian, Roll John
College of Nursing, Washington State University, Spokane, Washington; Program of Excellence in Addictions Research, Washington State University, Spokane, Washington; Translational Addiction Research Center, Washington State University, Spokane, Washington.
College of Nursing, Washington State University, Spokane, Washington.
Pain Manag Nurs. 2018 Dec;19(6):652-662. doi: 10.1016/j.pmn.2018.05.001. Epub 2018 Jun 21.
In the United States, chronic pain is experienced by over 39.4 million adults, many of whom are treated with opioid pain medications.
This research presents an interpretation of the experience of seeking pain relief for a group of people taking opioid pain medications whose pain is not adequately controlled.
A concurrent embedded mixed-methods design was used, including a Heideggerian hermeneutic qualitative approach that focuses on the participants' perceptions as a vehicle for understanding the phenomenon of seeking pain relief with descriptive quantitative data in a supporting role. Thirteen interviews and 15 surveys were analyzed, all of which met the following criteria: (1) self-reported chronic pain (persistent pain lasting a minimum of six months), (2) current use of prescription opioid medications, (3) pain not successfully controlled.
The analysis revealed a paradox, which we describe as being lost/finding myself in the health care system. This paradox became the overarching pattern of experience that subsumed several dynamic, overlapping practices described in the patterns: (1) seeking relief as suffering; (2) being classified as an addict but not an addict; (3) living with pain as remembering; and (4) experiencing treatment modalities as fickle possibilities.
Explication of and interpretive commentary on these patterns shift the focus from drug seeking to pain relief seeking behaviors in chronic pain sufferers. Such a shift could change the manner in which providers work with chronic pain sufferers to find appropriate treatment modalities.
在美国，超过3940万成年人经历慢性疼痛，其中许多人接受阿片类止痛药物治疗。
本研究对一组服用阿片类止痛药物但疼痛未得到充分控制的人群寻求疼痛缓解的经历进行解读。
采用同步嵌入式混合方法设计，包括一种海德格尔诠释学定性方法，该方法以参与者的认知为重点，将描述性定量数据作为辅助手段来理解寻求疼痛缓解这一现象。对13次访谈和15份调查问卷进行了分析，所有这些都符合以下标准：（1）自我报告有慢性疼痛（持续疼痛至少六个月），（2）目前正在使用处方阿片类药物，（3）疼痛未得到成功控制。
分析揭示了一个悖论，我们将其描述为在医疗保健系统中迷失/找回自我。这个悖论成为总体的体验模式，包含了模式中描述的几种动态、重叠的行为：（1）将寻求缓解视为痛苦；（2）被归类为成瘾者但又不是成瘾者；（3）带着疼痛生活如同记忆；（4）将治疗方式视为变幻无常的可能性。
对这些模式的阐释和解释性评论将焦点从寻求药物转向慢性疼痛患者寻求疼痛缓解的行为。这种转变可能会改变医疗服务提供者与慢性疼痛患者合作以找到合适治疗方式的方式。
