Giannitrapani Karleen F, Haverfield Marie C, Lo Natalie K, McCaa Matthew D, Timko Christine, Dobscha Steven K, Kerns Robert D, Lorenz Karl A
VA Palo Alto Health Care System, Center for Innovation to Implementation (Ci2i), Menlo Park, California.
Stanford University, Palo Alto, California.
Pain Med. 2020 Oct 1;21(10):2163-2171. doi: 10.1093/pm/pnaa016.
Screening for pain in routine care is one of the efforts that the Veterans Health Administration has adopted in its national pain management strategy. We aimed to understand patients' perspectives and preferences about the experience of being screened for pain in primary care.
Semistructured interviews captured patient perceptions and preferences of pain screening, assessment, and management.
We completed interviews with 36 patients: 29 males and seven females ranging in age from 28 to 94 years from three geographically distinct VA health care systems.
We evaluated transcripts using constant comparison and identified emergent themes.
Theme 1: Pain screening can "determine the tone of the examination"; Theme 2: Screening can initiate communication about pain; Theme 3: Screening can facilitate patient recall and reflection; Theme 4: Screening for pain may help identify under-reported psychological pain, mental distress, and suicidality; Theme 5: Patient recommendations about how to improve screening for pain.
Our results indicate that patients perceive meaningful, positive impacts of routine pain screening that as yet have not been considered in the literature. Specifically, screening for pain may help capture mental health concerns that may otherwise not emerge.
在常规护理中筛查疼痛是退伍军人健康管理局在其全国疼痛管理战略中采取的举措之一。我们旨在了解患者对在初级保健中接受疼痛筛查体验的看法和偏好。
半结构化访谈获取了患者对疼痛筛查、评估和管理的认知及偏好。
我们对36名患者进行了访谈，其中29名男性和7名女性，年龄在28岁至94岁之间，来自三个地理位置不同的退伍军人事务部医疗保健系统。
我们使用持续比较法评估访谈记录，并确定新出现的主题。
主题1：疼痛筛查可“确定检查的基调”；主题2：筛查可开启关于疼痛的交流；主题3：筛查可促进患者回忆和反思；主题4：疼痛筛查可能有助于识别报告不足的心理疼痛、精神困扰和自杀倾向；主题5：患者关于如何改进疼痛筛查的建议。
我们的结果表明，患者认为常规疼痛筛查具有有意义的积极影响，而这些影响在文献中尚未得到考虑。具体而言，疼痛筛查可能有助于发现那些否则可能不会出现的心理健康问题。
