慢性疼痛的军龄女性的生活体验:一项现象学研究。
The Lived Experience of Military Women With Chronic Pain: A Phenomenological Study.
机构信息
Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA 92110-2492, USA.
School of Nursing, San Diego State University, San Diego, CA 92182-4158, USA.
出版信息
Mil Med. 2023 May 16;188(5-6):1199-1206. doi: 10.1093/milmed/usac134.
INTRODUCTION
Chronic pain, a persistent or recurrent pain lasting more than 3 months, is a widespread problem among military women due to combat-related injuries and post-deployment stressors. Risk factors associated with chronic pain include gender, mental health, post-traumatic stress disorder, and prior physical or military sexual trauma. The most common prevalence of chronic pain is musculoskeletal (e.g., low back and neck), migraine, osteoarthritis, and fibromyalgia. Following deployment, 25% of military women are at risk for chronic pain. Military women are prescribed opioids for pain at a higher rate than men and are at risk for prescription opioid addiction. The unique medical needs of military women, including chronic pain, are poorly understood by health care providers and need to be addressed to achieve full integration into the military. The purpose of this study was to explore a typical day for military women living with chronic pain by examining the participants' daily life experiences.
MATERIAL AND METHODS
Using van Manen's approach, 13 active duty, retired, and veteran women were interviewed to explore these lived experiences. The study was approved by the Institutional Review Board at the University of San Diego.
RESULTS
Eight themes emerged from an analysis of the participants' experiences: (1) chronic pain is a frustrating, persistent, daily, and an hourly struggle; (2) resilience in living with chronic pain is the new normal; (3) mission first and the impact of invisible pain; (4) self-care management and internal locus of control with nonpharmacological therapies; (5) pain accepted and managed to improve quality of life; (6) coronavirus disease 2019 (COVID-19) diminished social interactions; (7) pain of sexual trauma is not reported; and (8) disparities in health care due to self-perception of provider bias as pain is not understood.
CONCLUSIONS
The study generated new knowledge in Force Health Protection, ensuring (1) a fit and operational readiness force; (2) pre- to post-deployment care for women warriors; and (3) access to health care. The study findings supported previous research and could help direct future research into nursing, medicine, and allied health treatments for military and veterans' gender-specific health care, education, and training. Furthermore, the military women in this study provided insight into the need for future research to explore unconscious gender bias, health disparities, and a raised awareness of military women living with chronic pain. Findings from this study merit further exploration using other qualitative research methodologies including mixed methods.
简介
慢性疼痛是一种持续或反复发作的疼痛,持续时间超过 3 个月,由于与战斗相关的伤害和部署后的压力源,在军事女性中较为普遍。与慢性疼痛相关的风险因素包括性别、心理健康、创伤后应激障碍以及先前的身体或军事性创伤。慢性疼痛最常见的是肌肉骨骼(例如,下背部和颈部)、偏头痛、骨关节炎和纤维肌痛。部署后,25%的军事女性有患慢性疼痛的风险。与男性相比,军事女性开具阿片类药物治疗疼痛的比例更高,并且有处方类阿片类药物成瘾的风险。军事女性的独特医疗需求,包括慢性疼痛,医护人员了解甚少,需要加以解决,以实现全面融入军队。本研究的目的是通过检查参与者的日常生活经验,探索患有慢性疼痛的现役、退伍和退役军人女性的典型一天。
材料与方法
采用范马南的方法,对 13 名现役、退伍和退役军人女性进行了访谈,以探讨这些生活经历。本研究得到了圣地亚哥大学机构审查委员会的批准。
结果
对参与者的经历进行分析后,出现了 8 个主题:(1)慢性疼痛是一种令人沮丧、持续、日常和每小时都在发生的斗争;(2)在患有慢性疼痛的情况下保持韧性是新常态;(3)任务第一和看不见的疼痛的影响;(4)自我护理管理和内部控制源与非药物疗法;(5)接受疼痛并加以管理以提高生活质量;(6)2019 年冠状病毒病(COVID-19)减少了社交互动;(7)性创伤的疼痛未被报告;(8)由于提供者偏见的自我认知导致医疗保健的差异,因为疼痛不被理解。
结论
该研究在部队健康保护方面产生了新知识,确保(1)一支适合且具备作战能力的部队;(2)为女兵战士提供部署前和部署后的护理;(3)获得医疗保健。该研究结果支持了先前的研究,并有助于指导未来的护理、医学和联合健康治疗研究,以满足军事人员和退伍军人的性别特定的医疗保健、教育和培训需求。此外,本研究中的军事女性提供了关于未来研究的见解,以探索无意识的性别偏见、健康差距以及提高对患有慢性疼痛的军事女性的认识。这项研究的结果值得进一步探索,可采用混合方法等其他定性研究方法。