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哥伦比亚兽医对犬猫疼痛知识与镇痛的调查

Survey of Pain Knowledge and Analgesia in Dogs and Cats by Colombian Veterinarians.

作者信息

Morales-Vallecilla Carlos, Ramírez Nicolas, Villar David, Díaz Maria Camila, Bustamante Sandra, Ferguson Duncan

机构信息

Facultad de Ciencias Agrarias Universidad de Antioquia, Medellín 050010, Colombia.

Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA.

出版信息

Vet Sci. 2019 Jan 10;6(1):6. doi: 10.3390/vetsci6010006.

Abstract

A questionnaire study was conducted among 131 veterinarians practicing in the city of Medellin, Colombia, to assess views on pain evaluation and management in dogs and cats. When pain recognition and quantification abilities were used as a perceived competence of proper pain assessment, only 83/131 (63.4%, confidence interval (CI) 0.55⁻0.72) were deemed to have satisfactory skills, with the rest considered to be deficient. There were 49/131 (37.4) veterinarians who had participated in continuing education programs and were more confident assessing pain, with an odds ratio (±standard error) of 2.84 ± 1.15 ( = 0.01; CI 1.27⁻6.32). In addition, the odds of using pain scales was 4.28 ± 2.17 ( < 0.01, CI 1.58⁻11.55) greater if they had also participated in continuing education programs. The term multimodal analgesia was familiar to 77 (58.7%) veterinarians who also claimed to use more than one approach to pain control. Nevertheless, homeopathy was the preferred alternative approach in 71/77 (92%). There were major misconceptions on side effects and/or contraindications for use of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) by most veterinarians. In addition, the lack of multimodal analgesia by at least 40% of the practitioners, combined with heavy reliance on weak analgesics (i.e., tramadol) or those with no proven record of efficacy (homeopathic remedies), denotes major deficits in education at the undergraduate level and a need for additional continuing education designed to fulfill the gaps in knowledge identified in this study, and overcome ideological convictions not supported by scientific evidence.

摘要

在哥伦比亚麦德林市执业的131名兽医中进行了一项问卷调查研究,以评估他们对犬猫疼痛评估和管理的看法。当将疼痛识别和量化能力作为正确疼痛评估的感知能力时,只有83/131(63.4%,置信区间(CI)0.55⁻0.72)被认为具有令人满意的技能,其余则被认为不足。有49/131(37.4%)的兽医参加了继续教育项目,对疼痛评估更有信心,优势比(±标准误差)为2.84±1.15(P = 0.01;CI 1.27⁻6.32)。此外,如果他们也参加了继续教育项目,使用疼痛量表的几率要高4.28±2.17(P < 0.01,CI 1.58⁻11.55)。77名(58.7%)兽医熟悉多模式镇痛一词,他们还声称使用不止一种疼痛控制方法。然而,顺势疗法是71/77(92%)兽医首选的替代方法。大多数兽医对阿片类药物和非甾体抗炎药(NSAIDs)的副作用和/或使用禁忌症存在重大误解。此外,至少40%的从业者缺乏多模式镇痛,同时严重依赖弱镇痛药(即曲马多)或那些没有经证实疗效记录的药物(顺势疗法药物),这表明本科教育存在重大缺陷,需要额外的继续教育来填补本研究中发现的知识空白,并克服没有科学证据支持的意识形态信念。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c895/6466334/cc85f2fb5285/vetsci-06-00006-g001.jpg

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