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运动神经元病的多种疼痛表现:一项定性研究,旨在为疼痛评估和疼痛管理提供信息。

The multiple faces of pain in motor neuron disease: a qualitative study to inform pain assessment and pain management.

机构信息

Department of Neuroscience, Uppsala University, Uppsala, Sweden.

出版信息

Disabil Rehabil. 2020 Jul;42(15):2123-2132. doi: 10.1080/09638288.2018.1555615. Epub 2019 Apr 24.

DOI:10.1080/09638288.2018.1555615
PMID:31014130
Abstract

The aim was to explore personal experiences of pain in people with motor neuron disease. Sixteen participants were individually interviewed on one occasion concerning their experiences of presentation, consequences, and management of pain. Qualitative content analysis with researcher triangulation was used to synthesize and interpret data. Four themes emerged as the result of the analysis: The important findings were the experiences of unpredictability of pain breakthroughs, the efforts required to manage pain, consequences for activity and quality of life, and the suffering induced by diminishment and neglect of pain from both patients and staff. Pain in motor neuron disease seems to have certain and multiple characteristics, which is why there is a need to develop and implement pain assessment methods adapted to this population. Such methods may help make pain more predictable, and increase the possibilities to provide effective and individually tailored pain treatment.IMPLICATIONS FOR REHABILITATIONPain is a common, but often neglected, ailment in motor neuro disease, which deserves more attention from health care.Staff should provide information about the pain being possible to treat successfully with medication, by contrast to the possibility of curing the disease itself.Pain assessments should be implemented during the entire course of the disease, covering a time frame long enough to cover characteristic fluctuations of pain.Whenever possible, facilitate the performance of painful activities of daily living as much as possible to make room for engagement in other personally valued activities of importance for individual quality of life.

摘要

目的在于探索运动神经元病患者的疼痛个人体验。16 名参与者在一次个体访谈中分别报告了他们的疼痛表现、后果和管理经历。采用研究人员三角测量的定性内容分析法对数据进行综合和解释。分析得出了四个主题:重要发现是疼痛突破的不可预测性体验、管理疼痛所需的努力、对活动和生活质量的后果,以及患者和医护人员对疼痛的忽视和忽视所引起的痛苦。运动神经元病中的疼痛似乎具有一定的和多种特征,这就是为什么需要开发和实施适用于该人群的疼痛评估方法。这些方法可以帮助提高疼痛的可预测性,并增加提供有效和个性化疼痛治疗的可能性。

对康复的启示

疼痛是运动神经元病的一种常见但经常被忽视的疾病,值得医疗保健更加关注。医护人员应提供有关疼痛的信息,说明可以通过药物成功治疗疼痛,而不是治愈疾病本身的可能性。疼痛评估应在整个疾病过程中进行,涵盖足够长的时间范围,以涵盖疼痛的特征性波动。只要有可能,尽可能地促进日常疼痛活动的完成,以便为参与其他对个人生活质量重要的个人重视的活动腾出空间。

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