Kouyanou K, Pither C E, Wessely S
Department of Psychological Medicine, St. Thomas' Hospital, London, United Kingdom.
Psychosom Med. 1997 Nov-Dec;59(6):597-604. doi: 10.1097/00006842-199711000-00007.
Although it is accepted that the etiology of chronic pain is multifactorial, little attention has been given to the possible role of iatrogenesis. The aim of the present study is to identify possible iatrogenic factors in chronic pain patients.
We report a cross-sectional study of 125 patients attending specialist pain clinics in South London. Data were collected using semistructured checklists. Patients were interviewed with a structured psychiatric interview and were given a questionnaire booklet to complete.
We found that possible iatrogenic factors, such as over-investigation, inappropriate information and advice given to patients as well as misdiagnosis, over-treatment, and inappropriate prescription of medication were common in this sample.
We suggest that future studies should take account of the role of the doctors, as well as that of the patients, in the etiology, and hence prevention of chronic pain.
尽管人们公认慢性疼痛的病因是多因素的,但医源性因素的可能作用却很少受到关注。本研究的目的是确定慢性疼痛患者中可能的医源性因素。
我们报告了一项对125名前往伦敦南部专科疼痛诊所就诊的患者的横断面研究。数据通过半结构化检查表收集。对患者进行了结构化的精神科访谈,并给他们一本问卷手册填写。
我们发现,在这个样本中,诸如过度检查、向患者提供不适当的信息和建议以及误诊、过度治疗和不适当的药物处方等可能的医源性因素很常见。
我们建议未来的研究应考虑医生以及患者在慢性疼痛的病因及预防中的作用。