Brewer Julie R, McDermott Katherine A, Greenberg Jonathan, Presciutti Alexander M, LaCamera Danielle E, Ritchie Christine S, Vranceanu Ana-Maria
Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Pain Manag. 2024 Oct-Nov;14(10-11):549-556. doi: 10.1080/17581869.2024.2432852. Epub 2024 Nov 27.
Chronic pain affects up to 37.8% of older adults with higher prevalence among those in under-resourced communities. While there are many treatments for chronic pain, there are complexities to treating under-resourced older adults in community clinics, including multimorbidity, barriers to treatment access, and varying degrees of openness to different treatment approaches. Understanding patient and clinic staff perceptions of treatment options for chronic pain is critical for implementing treatment approaches that will work sustainably in the community. This study aimed to understand clinic staff and patients' perspectives on chronic pain treatment experiences.
Focus groups and individual interviews were analyzed using a hybrid inductive-deductive approach.
Themes are: (1) Limited patient and clinic resources and availability affecting pain treatment experiences (e.g., copays, transportation challenges, and conflicting responsibilities), (2) Discrepancies in patient and staff approaches to treatment and the importance of trialing different pain management techniques to alleviate pain (e.g., trialing multiple treatments with varied success), and (3) Conflict between patients' desire for pain elimination vs. staffs' focus on symptom reduction and function (e.g., patient-staff disconnect).
These findings are important for determining how treatments can best fit the needs of under-resourced older adults with chronic pain.
慢性疼痛影响着高达37.8%的老年人,在资源匮乏社区的老年人中患病率更高。虽然慢性疼痛有多种治疗方法,但在社区诊所治疗资源匮乏的老年人存在诸多复杂情况,包括多种疾病并存、治疗获取障碍以及对不同治疗方法的接受程度不同。了解患者和诊所工作人员对慢性疼痛治疗选择的看法对于实施能在社区持续有效的治疗方法至关重要。本研究旨在了解诊所工作人员和患者对慢性疼痛治疗经历的看法。
采用归纳 - 演绎混合方法对焦点小组和个人访谈进行分析。
主题包括:(1)患者和诊所资源有限以及可及性影响疼痛治疗经历(如自付费用、交通挑战和责任冲突);(2)患者和工作人员在治疗方法上的差异以及尝试不同疼痛管理技术以减轻疼痛的重要性(如尝试多种治疗但效果各异);(3)患者消除疼痛的愿望与工作人员关注症状减轻和功能之间的冲突(如患者与工作人员之间的脱节)。
这些发现对于确定治疗如何最能满足资源匮乏的慢性疼痛老年人的需求非常重要。