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影响帕金森病患者疼痛管理实践的因素:一项定性描述性研究。

Factors Influencing Pain Management Practices in People With Parkinson's Disease: A Qualitative Descriptive Study.

作者信息

Mezzini Anthony, Kumar Saravana, Sharrad Sue, Harmon Joanne, Eckert Marion

机构信息

Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.

IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.

出版信息

Parkinsons Dis. 2025 Aug 1;2025:1231126. doi: 10.1155/padi/1231126. eCollection 2025.

Abstract

While Parkinson's disease (PD) is primarily recognized for its motor symptoms, several non-motor symptoms may also be present. Among these, pain is one of the most common and debilitating, arising from complex neurophysiological mechanisms that often interact with motor symptoms and comorbidities, leading to a diverse range of clinical presentations. Although a variety of pharmacological and nonpharmacological therapies are used to manage pain in PD, the factors influencing treatment practices remain underexplored, particularly within the Australian healthcare context. This study, therefore, aimed to explore, from the patients' perspective, factors that influence pain management practices among people with PD living in Australia. A qualitative descriptive research methodology using a maximum variation sampling strategy was used to recruit people with PD, living in Australia. Data were collected using individual, semistructured interviews and thematically analyzed. 18 participants shared their perspectives on the factors that influenced their pain management practices. Thematic analysis of interview data resulted in four themes: (1) recommendations from trusted sources; (2) explorative experimentation and solution seeking; (3) intervention and service provider characteristics; and (4) personal beliefs and abilities; and several subthemes. These findings highlight the complex nature of therapeutic decision-making from the perspective of people with PD, underscoring the interaction between external and internal influences. There is complexity and nuance in how people with PD make decisions about managing their pain. External and internal factors seem to influence therapeutic decision-making, while also highlighting notable gaps in the provision of PD pain care services. Understanding these complexities will be critical in developing accessible, effective, and patient-centered approaches to pain management within this population.

摘要

虽然帕金森病(PD)主要以其运动症状而被认知,但也可能存在一些非运动症状。其中,疼痛是最常见且使人衰弱的症状之一,它源于复杂的神经生理机制,这些机制常常与运动症状及合并症相互作用,导致多种多样的临床表现。尽管有多种药物和非药物疗法用于管理帕金森病患者的疼痛,但影响治疗实践的因素仍未得到充分探索,尤其是在澳大利亚的医疗环境中。因此,本研究旨在从患者的角度探索影响居住在澳大利亚的帕金森病患者疼痛管理实践的因素。采用最大差异抽样策略的定性描述性研究方法,招募居住在澳大利亚的帕金森病患者。通过个体半结构化访谈收集数据并进行主题分析。18名参与者分享了他们对影响其疼痛管理实践因素的看法。访谈数据的主题分析产生了四个主题:(1)来自可靠来源的建议;(2)探索性试验和寻求解决方案;(3)干预措施和服务提供者特征;(4)个人信念和能力;以及几个子主题。这些发现从帕金森病患者的角度突出了治疗决策的复杂性,强调了外部和内部影响之间的相互作用。帕金森病患者在决定如何管理疼痛方面存在复杂性和细微差别。外部和内部因素似乎会影响治疗决策,同时也凸显了帕金森病疼痛护理服务提供方面的显著差距。了解这些复杂性对于为该人群制定可及、有效且以患者为中心的疼痛管理方法至关重要。

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