University Medical Center Freiburg, University of Freiburg, Germany.
Pain Physician. 2021 Mar;24(2):165-173.
Worldwide, the COVID-19 pandemic has a significant impact on daily life. First studies describe a negative impact of pandemic stressors even on individuals without previous mental illnesses. The home lockdown and the shutdown of pain clinics make it difficult for all patients to get the healthcare they need.
The aim of this study was to investigate to what extent patients with chronic pain felt affected by the pandemic and its consequences on pain treatments, focussing on the beginning of the outbreak.
A prospective noninterventional study.
Medical University Center .
One-hundred and forty-nine patients, suffering from chronic pain, treated at a large German interdisciplinary pain center, were studied over a period of 2 months at the beginning of the pandemic. Data from patient charts and questionnaires were evaluated. Patients were asked about postponements or cancellations of pain therapy, the possible effect on pain levels, depression, anxiety and stress, and the impact of intensified hygiene measures. Results were compared to those from standardized and validated questionnaires from the same patients (German version of the depression, anxiety, and stress scale = DASS) at the time of the first contact in the pain clinic.
Eighty-four (56.4%) patients reported cancelled or postponed treatments during the pandemic. Those chronic pain patients with delayed or cancelled treatments reported significantly more pain and psychological distress. The delay or discontinuation of treatments resulted in a deterioration of symptoms. From the patients' point of view this deterioration was unrelated to the timing of treatment and not secondary to increased hygiene measures. In both groups, patients showed a significant amelioration of the DASS values compared to the values they had at the beginning of treatment, despite the negative effects of the COVID-19 pandemic on care structures. The majority of the patients do not think that the quality of pain treatment was significantly affected by the intensified hygiene requirements.
The limitations of the study are the small number of patients because of the limitation to a short period of time at the beginning of the pandemic and the return rate of 40.2% of the study consents.
Even in the event of a pandemic-related restriction of the care structures, patients with chronic pain benefit from pain therapy. Limitations such as the increased hygiene measures caused by the pandemic were not considered detrimental to the therapeutic measures.
在全球范围内,COVID-19 大流行对日常生活产生了重大影响。最初的研究表明,即使是没有先前精神疾病的个体,大流行压力也会产生负面影响。家庭封锁和疼痛诊所的关闭使得所有患者都难以获得所需的医疗保健。
本研究旨在调查慢性疼痛患者在多大程度上受到大流行及其对疼痛治疗的影响,重点关注大流行开始时的情况。
前瞻性非干预性研究。
医学中心。
在大流行开始的两个月内,对在德国一家大型跨学科疼痛中心接受治疗的 149 名慢性疼痛患者进行了研究。评估了患者病历和问卷的数据。询问患者疼痛治疗的延迟或取消、对疼痛水平、抑郁、焦虑和压力的可能影响,以及强化卫生措施的影响。将结果与同一患者在疼痛诊所首次就诊时的标准化和验证过的问卷(德国版抑郁、焦虑和压力量表 = DASS)进行比较。
84 名(56.4%)患者报告在大流行期间治疗被取消或推迟。那些治疗延迟或取消的慢性疼痛患者报告疼痛和心理困扰明显增加。治疗的延迟或停止导致症状恶化。从患者的角度来看,这种恶化与治疗时间无关,也不是由于增加的卫生措施造成的。尽管 COVID-19 大流行对护理结构产生了负面影响,但两组患者的 DASS 值均与治疗开始时相比显著改善。大多数患者认为,强化卫生要求并没有显著影响疼痛治疗的质量。
研究的局限性在于患者数量较少,因为这是在大流行开始时的短时间内进行的,并且只有 40.2%的研究同意者返回。
即使在大流行相关的护理结构限制的情况下,慢性疼痛患者也能从疼痛治疗中受益。大流行带来的增加的卫生措施等限制因素并没有被认为对治疗措施有害。