Johns Hopkins School of Nursing, NOVA Interventional Pain Management, Edgewood, Maryland.
Johns Hopkins School of Nursing, Baltimore, Maryland.
Pain Manag Nurs. 2020 Apr;21(2):157-164. doi: 10.1016/j.pmn.2019.06.016. Epub 2019 Sep 11.
Opioid analgesic misuse and abuse has given rise to an epidemic that has added to an increase in opioid-related overdoses and deaths. Adults with persistent noncancer pain (PNCP) are primarily treated with opioid analgesics. Many remain on these medications long term. Most of these patients are unaware of other effective measures for managing PNCP, such as nonpharmacologic modalities (NPMs). This lack of familiarity with NPMs presents a key contributor to the problem of NPM underuse among adult PNCP patients. This integrative review sought to identify key factors that contribute to NPMs underuse and the effect of education on patients' adoption or use for PNCP management.
Integrative review.
A literature search was conducted using PubMed, CINAHL, Embase, Cochrane, and hand-searching of the literature published between 2002 and November 2017.
REVIEW/ANALYSIS METHODS: Systematic screening using the Johns Hopkins Nursing evidence appraisal tools yielded articles that were analyzed and synthesized to identify themes, and patterns.
Nineteen research articles were identified with these main themes: NPMs are effective in PNCP management, lack of familiarity with NPMs influences patients' willingness to try them, and access to local NPMs must be addressed to facilitate use.
Findings suggest that patient education about NPMs has the potential to motivate patients to try these modalities, which may increase overall use of NPMs for PCNP. Nurses could play a vital role in ensuring evidence-based NPMs are introduced to PNCP patients, which could increase patients' use of these measures and improve outcomes.
阿片类镇痛药的滥用已引发一场流行,导致阿片类药物相关过量和死亡人数增加。患有持续性非癌性疼痛(PNCP)的成年人主要接受阿片类镇痛药治疗。许多人长期服用这些药物。这些患者中的大多数人不知道其他有效治疗 PNCP 的方法,例如非药物治疗模式(NPMs)。对 NPMs 的不熟悉是导致成年 PNCP 患者对 NPMs 使用率低的一个关键因素。这项综合评价旨在确定导致 NPMs 使用率低的关键因素,以及教育对患者接受或使用 NPMs 管理 PNCP 的影响。
综合评价。
使用 PubMed、CINAHL、Embase、Cochrane 进行文献检索,并对 2002 年至 2017 年 11 月期间发表的文献进行手工检索。
审查/分析方法:使用约翰霍普金斯护理证据评估工具进行系统筛选,得出分析和综合文章,以确定主题和模式。
确定了 19 篇研究文章,这些文章的主要主题有:NPMs 在 PNCP 管理中是有效的,对 NPMs 的不熟悉会影响患者尝试的意愿,必须解决当地 NPMs 的获取问题,以促进使用。
研究结果表明,对 NPMs 的患者教育有可能激励患者尝试这些治疗模式,从而可能增加整体使用 NPMs 治疗 PCNP。护士可以在确保向 PNCP 患者介绍基于证据的 NPMs 方面发挥重要作用,从而增加患者对这些措施的使用并改善结果。