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“出院并不意味着结束”:探索慢性疼痛青年成人向社区自我管理过渡的成功经验:一项定性研究

"Discharge doesn't mean the end": Exploring success in discharge to community self-management for young adults living with chronic pain: A qualitative study.

作者信息

Kassam Souraiya, Wong Emi, Thompson Marysa, Tran Todd, Bosma Rachael, Sheffe Sarah

机构信息

Temerty Faculty of Medicine, Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.

Women's College Hospital, Toronto Academic Pain Medicine Institute, Toronto, Ontario, Canada.

出版信息

Can J Pain. 2024 Apr 26;8(1):2346943. doi: 10.1080/24740527.2024.2346943. eCollection 2024.

Abstract

BACKGROUND

Living with chronic pain as a young adult (YA) can impact the physical, emotional, social, cognitive, and role function domains of life. Once YAs receive care for their specialist chronic pain care they are expected to self-navigate a complex health care system to transition to community-based care (i.e. primary care). Inadequate discharge planning may increase the unique difficulties YAs face in self-management, which may lead to adverse health outcomes, suboptimal discharge, and a need to reaccess care.

AIMS

The purpose of this qualitative study is to explore how YAs with chronic pain define a successful discharge transition from a health service delivery model of specialized chronic pain services setting to self-management in a community setting (i.e. primary care) and contextual factors that promote discharge success.

METHODS

This qualitative study included young adults with chronic pain. Data were obtained through semistructured interviews, which were transcribed verbatim and analyzed using inductive content analysis.

RESULTS

Ten participants identified that successful discharge includes the following considerations: (1) acknowledging the tension between moving forward and looking back, (2) a collaborative discharge process, and (3) the need for ongoing, relevant resources and support.

CONCLUSION

This study provides a deeper understanding of how YAs with chronic pain characterize success in the discharge transition from specialized chronic pain services to community self-management. Our findings highlight the importance of provider-patient collaboration during the discharge planning process to develop a patient-centered self-management plan that incorporates community resources tailored to the needs of the individual to promote an optimal discharge.

摘要

背景

作为年轻成年人(YA),长期忍受慢性疼痛会对生活的身体、情感、社交、认知和角色功能等领域产生影响。一旦年轻成年人接受了专科慢性疼痛护理,他们就需要自行应对复杂的医疗保健系统,以过渡到基于社区的护理(即初级护理)。出院计划不完善可能会增加年轻成年人在自我管理方面面临的独特困难,这可能导致不良健康后果、不理想的出院情况以及再次就医的需求。

目的

这项定性研究的目的是探讨患有慢性疼痛的年轻成年人如何定义从专科慢性疼痛服务的医疗服务提供模式成功过渡到社区环境(即初级护理)中的自我管理,以及促进出院成功的背景因素。

方法

这项定性研究纳入了患有慢性疼痛的年轻成年人。通过半结构化访谈获取数据,访谈内容逐字转录,并采用归纳性内容分析法进行分析。

结果

十名参与者确定,成功出院包括以下几点考虑:(1)认识到向前看和向后看之间的矛盾,(2)协作性的出院过程,以及(3)对持续的、相关资源和支持的需求。

结论

本研究更深入地了解了患有慢性疼痛的年轻成年人如何界定从专科慢性疼痛服务向社区自我管理的出院过渡中的成功。我们的研究结果强调了在出院计划过程中提供者与患者协作的重要性,以制定以患者为中心的自我管理计划,该计划纳入根据个人需求量身定制的社区资源,以促进理想的出院。

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本文引用的文献

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