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探索退伍军人在退伍军人事务部社区护理网络中获得慢性疼痛治疗的经历。

Exploring Veterans' Experiences Accessing Chronic Pain Treatment in the VA Community Care Network.

作者信息

Scorsone Krista L, Frank Joseph W

机构信息

Regis University, Rueckert Hartman College for Health Professions, Denver, CO, USA.

Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora, CO, USA.

出版信息

J Gen Intern Med. 2024 Dec;39(16):3190-3195. doi: 10.1007/s11606-024-09023-y. Epub 2024 Sep 16.

Abstract

BACKGROUND

Chronic pain is common among Veterans, and rural Veterans commonly struggle obtaining chronic pain care due to large travel distances to the nearest Veterans Affairs (VA) medical center. In 2019, the VA established the Community Care Network (CCN) to provide Veterans access to care in community-based settings, including chronic pain management.

OBJECTIVE

To explore the experiences of rural Veterans receiving chronic pain treatment in the VA CCN, including their perceptions about perceived barriers, facilitators, and benefits to accessing comprehensive chronic pain management.

DESIGN

Qualitative study using semi-structured interviews.

PARTICIPANTS

Ten rural Veterans receiving chronic pain management in the VA CCN took part in a qualitative interview focused on their experiences accessing and utilizing the VA CCN.

APPROACH

A descriptive qualitative approach was used. Major themes were identified through thematic content analysis.

KEY RESULTS

Veterans described challenges navigating the approval process, finding approved CCN providers for pain management, and they perceived that communication between the VA and community providers was not seamless. Once enrolled in the CCN, however, Veterans valued the freedom to choose providers specializing in pain management within their local communities, timely access to appointments, and opportunities to explore a wider range of pain treatment options and alternative therapies, in addition to traditional medical interventions, all in their local community.

CONCLUSIONS

As the CCN seeks to improve collaboration between VA and community providers, recognition of Veterans' experiences could serve to drive the development of network improvements. Findings reported here suggest that Veterans preferred obtaining care in the CCN once they could navigate administrative complexity to access it. Thus, efforts to streamline VA administrative requirements for initiating CCN care would better support Veterans in meeting their needs in this context.

摘要

背景

慢性疼痛在退伍军人中很常见,农村退伍军人通常因前往距离最近的退伍军人事务部(VA)医疗中心路途遥远而难以获得慢性疼痛护理。2019年,退伍军人事务部建立了社区护理网络(CCN),以使退伍军人能够在社区环境中获得护理,包括慢性疼痛管理。

目的

探讨农村退伍军人在退伍军人事务部社区护理网络中接受慢性疼痛治疗的经历,包括他们对获得全面慢性疼痛管理的感知障碍、促进因素和益处的看法。

设计

采用半结构化访谈的定性研究。

参与者

10名在退伍军人事务部社区护理网络中接受慢性疼痛管理的农村退伍军人参加了一次定性访谈,重点是他们使用退伍军人事务部社区护理网络的经历。

方法

采用描述性定性方法。通过主题内容分析确定主要主题。

主要结果

退伍军人描述了在审批过程中遇到的挑战、寻找经批准的社区护理网络疼痛管理提供者的困难,他们认为退伍军人事务部与社区提供者之间的沟通并不顺畅。然而,一旦加入社区护理网络,退伍军人重视能够在当地社区选择专门从事疼痛管理的提供者的自由、及时获得预约的机会,以及除了传统医疗干预之外,还能在当地社区探索更广泛的疼痛治疗选择和替代疗法的机会。

结论

随着社区护理网络寻求改善退伍军人事务部与社区提供者之间的合作,了解退伍军人的经历有助于推动网络改进的发展。此处报告的结果表明,一旦退伍军人能够克服行政复杂性以获得社区护理网络的服务,他们更愿意在其中接受护理。因此,简化退伍军人事务部启动社区护理网络护理的行政要求的努力,将更好地支持退伍军人在这种情况下满足他们的需求。

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