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利用初级保健使服务不足的患者参与慢性疼痛的心理干预。

Utilizing primary care to engage underserved patients in a psychological intervention for chronic pain.

机构信息

Henry Ford Health, Behavioral Health, Detroit, MI, USA.

Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA.

出版信息

Prim Health Care Res Dev. 2024 Oct 25;25:e54. doi: 10.1017/S1463423624000471.

DOI:10.1017/S1463423624000471
PMID:39450755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11569855/
Abstract

BACKGROUND

Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients.

METHODS

There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol.

RESULTS

There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males.

CONCLUSIONS

Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.

摘要

背景

尽管心理干预可以用于改善慢性疼痛管理,但服务不足的人群(即种族少数群体和社会经济地位较低的人群)可能不太可能接受此类服务。本研究的目的是探讨在初级保健诊所提供慢性疼痛心理干预是否可以成为成功吸引服务不足患者的一种方法。

方法

在一个社会经济和种族多样化的城市的初级保健诊所,有 220 名慢性疼痛患者被邀请讨论参加一项为期五节的慢性疼痛心理干预的试点随机对照试验。患者的初级保健提供者使用温暖交接模式向他们介绍了这项研究。我们比较了参加研究和拒绝参加的患者在社会人口统计学方面是否存在差异。

结果

参加研究和拒绝参加的患者在种族、年龄、保险类型和家庭收入方面没有差异。然而,女性比男性更有可能参加研究。

结论

在初级保健诊所招募患者参加慢性疼痛心理干预试验似乎可以有效地吸引黑人和社会经济地位较低的患者以及那些有政府保险的患者。因此,在初级保健诊所提供慢性疼痛心理干预可能会鼓励少数族裔和社会经济地位较低的人参与。

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本文引用的文献

1
A brief psychological intervention for chronic pain in primary care: Examining long-term effects from a pilot randomized clinical trial.基层医疗中的慢性疼痛的简要心理干预:一项试点随机临床试验的长期效果研究。
Pain Pract. 2022 Jul;22(6):564-570. doi: 10.1111/papr.13134. Epub 2022 Jun 14.
2
A Brief Psychological Intervention for Chronic Pain in Primary Care: A Pilot Randomized Controlled Trial.初级保健中慢性疼痛的简要心理干预:一项初步随机对照试验。
Pain Med. 2021 Jul 25;22(7):1603-1611. doi: 10.1093/pm/pnaa444.
3
Brief Cognitive Behavioral Therapy For Chronic Pain: Results From a Clinical Demonstration Project in Primary Care Behavioral Health.简短认知行为疗法治疗慢性疼痛:初级保健行为健康中的临床示范项目结果。
Clin J Pain. 2019 Oct;35(10):809-817. doi: 10.1097/AJP.0000000000000747.
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Integrated primary care: patient perceptions and the role of mental health stigma.综合初级保健:患者认知与心理健康污名的作用。
Prim Health Care Res Dev. 2018 Jun 19;20:e48. doi: 10.1017/S1463423618000403.
5
Are pilot trials useful for predicting randomisation and attrition rates in definitive studies: A review of publicly funded trials.先导试验对预测确定性研究中的随机化和损耗率是否有用:对公共资助试验的综述。
Clin Trials. 2018 Apr;15(2):189-196. doi: 10.1177/1740774517752113. Epub 2018 Jan 23.
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Embedding a psychologist into primary care increases access to behavioral health services.在初级保健中配备一名心理学家可增加获得行为健康服务的机会。
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Physical health and gender as risk factors for usage of services for mental illness.身体健康和性别作为精神疾病服务使用的风险因素。
J Epidemiol Community Health. 2014 Oct;68(10):971-8. doi: 10.1136/jech-2014-203844. Epub 2014 Jun 25.
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Evaluation of integrated psychological services in a university-based primary care clinic.大学基层医疗诊所综合心理服务评估
J Clin Psychol Med Settings. 2014 Mar;21(1):19-32. doi: 10.1007/s10880-013-9378-8.
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Sex differences in pain: a brief review of clinical and experimental findings.性别与疼痛差异:临床与实验研究的简要综述。
Br J Anaesth. 2013 Jul;111(1):52-8. doi: 10.1093/bja/aet127.
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African American men and women's attitude toward mental illness, perceptions of stigma, and preferred coping behaviors.非裔美国男性和女性对精神疾病的态度、对污名的看法,以及他们偏好的应对行为。
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