Chronic pain management in the emergency department: a survey of attitudes and beliefs.
Chronic pain management in the emergency department: a survey of attitudes and beliefs.
复制标题
急诊科的慢性疼痛管理：态度和信念调查。
DOI：
10.1111/j.1526-4637.2007.00400.x
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Bertakis,KleaD
中科院分区：
文献类型：
--
作者：
Wilsey,BarthL;Fishman,ScottM;Ogden,Christine;Tsodikov,Alexander;Bertakis,KleaD
目的：急诊科（ED）对于提供慢性疼痛护理来说可能是一个特别具有挑战性的环境。这项研究试图确定患者和医疗服务提供者对非癌症相关慢性疼痛的看法是否会影响急诊室疼痛的评估和管理。干预。我们调查了 103 名因慢性疼痛而到急诊室就诊的患者、34 名急诊医生和 44 名急诊护士，以评估 15 种可能的障碍对管理急诊室慢性疼痛的影响。结果。患者比医疗服务提供者更有可能相信他们的疼痛必须有诊断出的身体成分才能得到治疗。医疗服务提供者比患者更有可能相信患者来急诊室是因为他们缺乏初级保健医生。所有人都同意，慢性疼痛治疗不是急诊室的优先事项，成瘾、依赖、转移和伪造处方的可能性很低。结论。慢性疼痛患者可能需要放心，即使没有客观体征或放大的症状，他们的疼痛也会得到治疗。医疗服务提供者可能错误地认为，由于缺乏初级保健医生，这些患者才会被送往急诊室。医疗服务提供者和患者似乎认为在急诊室治疗慢性疼痛的优先级较低。两组人都可能低估了在这种情况下开阿片类药物所固有的问题。
Objective.The emergency department (ED) can be a particularly challenging environment in which to offer care for chronic pain. This study tried to determine if beliefs held by patients and providers about noncancer-related chronic pain affect evaluation and management of pain in ED.Intervention.We surveyed 103 patients presenting to the ED with chronic pain, 34 ED physicians, and 44 ED nurses to assess the influence of 15 possible barriers to managing chronic pain in the ED.Results.Patients were significantly more likely than providers to believe that their pain had to have a diagnosed physical component to be treated. Providers were significantly more likely than patients to believe that patients came to the ED because they lacked a primary care physician. All agreed that chronic pain treatment was not a priority in the ED and the potential for addiction, dependence, diversion, and forged prescriptions was low.Conclusions.Patients in chronic pain may need to be reassured that their pain will be treated, even in the absence of objective signs or magnified symptoms. Providers may wrongly believe that lack of a primary care physician brings these patients to the ED. Providers and patients appear to believe that treating chronic pain in the ED has a low priority. Both groups may underestimate the problems inherent with prescribing opioids in this setting.