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在萨斯喀彻温省北部的克里社区进行社区主导的疼痛评估。

Community directed assessment of pain in a northern Saskatchewan Cree community.

机构信息

College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Angelique Canada Health Center, Pelican Narrows, Saskatchewan, Canada.

出版信息

Int J Circumpolar Health. 2024 Dec;83(1):2300858. doi: 10.1080/22423982.2023.2300858. Epub 2024 Jan 7.

Abstract

Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an Elder and a Knowledge Keeper. Phase two was a pilot of the CDPS utilised during virtual physiotherapy sessions for chronic back pain. Twenty-seven participants completed the pre-physiotherapy treatment questionnaires, and 10 participants engaged in semi-structured interviews (9 community members; 1 healthcare provider). A weighted kappa analysis yielded k = 0.696, indicating a good agreement between the CDPS and Faces Pain Scale-Revised in terms of documenting participants' pain. Qualitative data from interviews with community members revealed three major themes: 1) Learnings Regarding Pain Scales, 2) Patient Centered Care; and 3) Strength-Based Solutions for Improving Pain Communication. Two themes were uncovered through conversations with the HCP: 1) Perspectives on CDPS and 2) Healthcare Provider Experiences Communicating about Pain. Moreover, a patient-centredcentred approach is important to ensure comprehensive pain assessments.

摘要

在萨斯喀彻温省北部的克里族社区佩利肯湾,当地的土著长老顾问指出,西方的疼痛量表可能无法准确评估他们社区内的疼痛。本研究采用混合方法研究设计,包括两个阶段。第一阶段是与一位长老和一位知识守护者合作开发疼痛量表。第二阶段是在慢性背痛的虚拟物理治疗期间试用 CDPS。27 名参与者完成了物理治疗前的治疗问卷,10 名参与者接受了半结构化访谈(9 名社区成员;1 名医疗保健提供者)。加权 kappa 分析得出 k=0.696,表明 CDPS 和修订后的面部疼痛量表在记录参与者疼痛方面具有良好的一致性。来自与社区成员访谈的定性数据揭示了三个主要主题:1)关于疼痛量表的学习;2)以患者为中心的护理;3)改善疼痛沟通的基于优势的解决方案。通过与 HCP 的对话揭示了两个主题:1)对 CDPS 的看法;2)医疗保健提供者在疼痛沟通方面的经验。此外,以患者为中心的方法对于确保全面的疼痛评估很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8685/10773658/21e5599c86c4/ZICH_A_2300858_F0001_OC.jpg

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