Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA.
Center on Stress & Health, University of California Irvine, Irvine, CA, USA.
J Clin Psychol Med Settings. 2021 Dec;28(4):757-770. doi: 10.1007/s10880-021-09763-7. Epub 2021 Feb 9.
This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain-the pain-opioid relation was stronger for patients without an anxiety disorder than for patients with an anxiety diagnosis. Instead, physicians were more likely to place non-opioid analgesic orders to manage the pain of patients with anxiety disorders. Findings imply that pain management decisions might be influenced by patient's mental health.
本研究旨在探讨与被诊断为精神健康状况的患者相比，没有焦虑/情绪障碍的儿科住院患者在应对疼痛时是否更有可能接受阿片类药物治疗。使用横断面住院电子病历数据检验了研究问题。采用倾向评分匹配法将有障碍的患者与无障碍的患者进行匹配（焦虑分析：N=2892；情绪分析：N=1042）。尽管患有焦虑症和情绪障碍的患者经历了更大的疼痛，但医生为这些患者开阿片类药物的可能性较小。分析还揭示了焦虑与疼痛之间的相互作用——对于没有焦虑障碍的患者，疼痛-阿片类药物的关系比有焦虑诊断的患者更强。相反，医生更有可能开出非阿片类镇痛药来治疗焦虑症患者的疼痛。研究结果表明，疼痛管理决策可能受到患者心理健康的影响。
