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促进和阻碍慢性疼痛患者同伴支持干预措施实施的因素:一项定性研究。

Facilitators and Barriers to Implementation of a Peer Support Intervention for Patients with Chronic Pain: A Qualitative Study.

机构信息

VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana.

Department of Health Sciences, Indiana University-Purdue University, Indianapolis, Indiana.

出版信息

Pain Med. 2019 Jul 1;20(7):1311-1320. doi: 10.1093/pm/pny229.

Abstract

OBJECTIVE

Pain self-management information and support, delivered by peers, are a potentially useful approach to help patients who are struggling to manage their chronic pain. Before implementation into clinical settings, it is important to understand factors that may influence the success of implementation. The purpose of this study was to explore facilitators and barriers to implementation of peer support for chronic pain.

DESIGN

Semistructured interviews were conducted with clinicians who provide care to patients with chronic pain, regarding their perceptions of the proposed peer support intervention.

SETTING

A single US Veterans Affairs Medical Center.

SUBJECTS

Using maximum variation sampling, 15 providers were interviewed (11 women, four men). Clinicians' disciplines included primary care, physical therapy, nursing, clinical psychology, social work, and pharmacy.

RESULTS

Findings indicated that clinicians 1) had an overall positive perception of the intervention; 2) had specific intervention outcomes they wanted for patients; 3) anticipated that the intervention could positively influence their role; 4) anticipated barriers to intervention participation and maintenance; and 5) had concerns regarding peer coach selection. Findings are discussed in the context of the Consolidated Framework for Implementation Research.

CONCLUSIONS

Understanding clinician perceptions of a peer support intervention is critical for successful implementation. The feedback collected in this study will facilitate implementation of the intervention on a broader scale, allowing more patients to benefit.

摘要

目的

由同伴提供的疼痛自我管理信息和支持,是一种帮助那些难以控制慢性疼痛的患者的潜在有用方法。在将其引入临床环境之前,了解可能影响实施成功的因素非常重要。本研究的目的是探讨实施同伴支持治疗慢性疼痛的促进因素和障碍。

设计

对为慢性疼痛患者提供护理的临床医生进行了半结构化访谈,了解他们对拟议的同伴支持干预措施的看法。

地点

美国一家退伍军人事务医疗中心。

受试者

通过最大变异抽样,对 15 名提供者进行了访谈(11 名女性,4 名男性)。临床医生的专业包括初级保健、物理治疗、护理、临床心理学、社会工作和药学。

结果

研究结果表明,临床医生 1)对干预措施总体持积极看法;2)对患者有具体的干预结果期望;3)预计干预措施将对其角色产生积极影响;4)预计干预参与和维持的障碍;5)对同伴教练的选择表示担忧。研究结果在实施研究综合框架的背景下进行了讨论。

结论

了解临床医生对同伴支持干预措施的看法对于成功实施至关重要。本研究收集的反馈将促进更广泛地实施干预措施,使更多患者受益。

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