Swanson D W, Swenson W M, Maruta T, McPhee M C
Mayo Clin Proc. 1976 Jul;51(7):401-8.
A program for the management of patients with treatment-resistant pain involves behavior modification, physical treatment, medication management, and counseling. The first 50 patients were characterized by pain of many years' duration, multiple operations, treatment failures, prolonged disability, compensation factors, and dependency on medication. In addition, they demonstrated loss of intellectual efficiency and were more psychologically deviant than the general medical population. Management problems were encountered in the following areas: patient acceptance, drug seeking, complicating psychopathology, complicating physical disorders, group dynamics, family reactions, and staff morale. Fifty-four percent of patients achieved moderate to marked improvement.
一个针对难治性疼痛患者的管理项目包括行为矫正、物理治疗、药物管理和咨询。首批50名患者的特点是疼痛持续多年、接受过多次手术、治疗失败、长期残疾、有赔偿因素以及对药物有依赖性。此外，他们表现出智力效率下降，且比普通医疗人群在心理上更偏离常态。在以下方面遇到了管理问题：患者接受度、寻药行为、复杂的精神病理学、复杂的身体疾病、群体动态、家庭反应以及工作人员士气。54%的患者取得了中度至显著的改善。
