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加拿大以患者为中心的疼痛护理决策需求评估:DECIDE-PAIN 研究方案。

Decisional needs assessment for patient-centred pain care in Canada: the DECIDE-PAIN study protocol.

机构信息

Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada

Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada.

出版信息

BMJ Open. 2023 May 8;13(5):e066189. doi: 10.1136/bmjopen-2022-066189.

Abstract

INTRODUCTION

The 2021 Action Plan for Pain from the Canadian Pain Task Force advocates for patient-centred pain care at all levels of healthcare across provinces. Shared decision-making is the crux of patient-centred care. Implementing the action plan will require innovative shared decision-making interventions, specifically following the disruption of chronic pain care during the COVID-19 pandemic. The first step in this endeavour is to assess current decisional needs (ie, decisions most important to them) of Canadians with chronic pain across their care pathways.

METHODS AND ANALYSIS

Grounded in patient-oriented research approaches, we will perform an online population-based survey across the ten Canadian provinces. We will report methods and data following the CROSS reporting guidelines.The Léger Marketing company will administer the online population-based survey to its representative panel of 500 000 Canadians to recruit 1646 adults (age ≥18 years old) with chronic pain according to the definition by the International Association for the Study of Pain (eg, pain ≥12 weeks). Based on the Ottawa Decision Support Framework, the self-administered survey has been codesigned with patients and contain six core domains: (1) healthcare services, consultation and postpandemic needs, (2) difficult decisions experienced, (3) decisional conflict, (4) decisional regret, (5) decisional needs and (6) sociodemographic characteristics. We will use several strategies such as random sampling to improve survey quality. We will perform descriptive statistical analysis. We will identify factors associated with clinically significant decisional conflict and decision regret using multivariate analyses.

ETHICS AND DISSEMINATION

Ethics was approved by the Research Ethics Board at the Research Centre of the Centre Hospitalier Universitaire de Sherbrooke (project #2022-4645). We will codesign knowledge mobilisation products with research patient partners (eg, graphical summaries and videos). Results will be disseminated via peer-reviewed journals and national and international conferences to inform the development of innovative shared decision-making interventions for Canadians with chronic pain.

摘要

简介

加拿大疼痛工作组的 2021 年疼痛行动计划主张在各省各级医疗保健中提供以患者为中心的疼痛护理。共同决策是以患者为中心护理的核心。实施该计划将需要创新的共同决策干预措施,特别是在 COVID-19 大流行期间慢性疼痛护理中断之后。这方面努力的第一步是评估加拿大各地慢性疼痛患者在其护理途径中最重要的决策需求。

方法和分析

基于以患者为导向的研究方法,我们将在加拿大的十个省份进行一项基于人群的在线调查。我们将按照 CROSS 报告指南报告方法和数据。莱杰营销公司将利用其代表 50 万加拿大人的小组对在线人群进行调查,根据国际疼痛研究协会的定义(例如,疼痛持续时间≥12 周)招募 1646 名患有慢性疼痛的成年人(年龄≥18 岁)。根据渥太华决策支持框架,该自我管理的调查是与患者共同设计的,包含六个核心领域:(1)医疗保健服务、咨询和大流行后需求;(2)经历的困难决策;(3)决策冲突;(4)决策遗憾;(5)决策需求;(6)社会人口学特征。我们将使用随机抽样等多种策略来提高调查质量。我们将进行描述性统计分析。我们将使用多元分析确定与临床显著决策冲突和决策遗憾相关的因素。

伦理和传播

伦理已获得舍布鲁克大学健康中心研究中心研究伦理委员会的批准(项目#2022-4645)。我们将与研究患者伙伴共同设计知识传播产品(例如,图形摘要和视频)。结果将通过同行评议的期刊以及国家和国际会议传播,为加拿大慢性疼痛患者的创新共同决策干预措施的制定提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4f/10173373/41bc65fbf056/bmjopen-2022-066189f01.jpg

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