Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
St. John's Rehab, Sunnybrook Research Institute, Toronto, Ontario, Canada.
J Spinal Cord Med. 2020 May;43(3):280-297. doi: 10.1080/10790268.2018.1523776. Epub 2018 Oct 18.
Pain and depression are two prevalent secondary complications associated with spinal cord injury (SCI) that negatively impact health and well-being. Self-management strategies are growing in popularity for helping people with SCI to cope with their pain and depression. However, there is still a lack of research on which approaches are best suited for this population. The aim of this scoping review was to determine what is known about the self-management of pain and depression through the use of pharmacological and non-pharmacological therapies in adults with SCI. Seven electronic databases were searched for articles published between January 1, 1990 and June 13, 2017. Grey literature was searched and additional articles were identified by manually searching the reference lists of included articles. Overall, forty-two articles met the inclusion criteria; with the majority reporting on the self-management of pain, rather than on depression or on both complications. Non-pharmacological interventions were more likely to include self-management strategies than pharmacological interventions. A limited number of studies included all of the core self-management tasks and skills. There are significant knowledge gaps on effective self-management interventions for pain and depression post-SCI. There is a need to develop interventions that are multi-faceted, which include both pharmacological and non-pharmacological therapies to address multimorbidity.
疼痛和抑郁是与脊髓损伤(SCI)相关的两种常见的继发性并发症,它们对健康和幸福感有负面影响。自我管理策略越来越受到人们的欢迎,可帮助 SCI 患者应对疼痛和抑郁。然而,对于哪种方法最适合该人群,仍缺乏研究。本综述旨在确定在成人 SCI 患者中,使用药理学和非药理学疗法来管理疼痛和抑郁的自我管理方法的相关知识。在 1990 年 1 月 1 日至 2017 年 6 月 13 日期间,检索了七个电子数据库以获取文章。通过手工搜索纳入文章的参考文献,还搜索了灰色文献并确定了其他文章。总体而言,有 42 篇文章符合纳入标准;其中大多数报告了疼痛的自我管理,而不是抑郁或两种并发症的自我管理。非药理学干预比药理学干预更有可能包括自我管理策略。少数研究包括了所有核心自我管理任务和技能。SCI 后疼痛和抑郁的有效自我管理干预措施方面存在重大知识空白。需要开发多方面的干预措施,包括药理学和非药理学疗法,以解决多种疾病。