Vulvodynia, "A Really Great Torturer": A Mixed Methods Pilot Study Examining Pain Experiences and Drug/Non-drug Pain Relief Strategies.
Vulvodynia, "A Really Great Torturer": A Mixed Methods Pilot Study Examining Pain Experiences and Drug/Non-drug Pain Relief Strategies.
复制标题
Vulvodynia，“一个真正伟大的折磨者”：一项检查疼痛经历和药物/非药物止痛策略的混合方法试点研究。
DOI：
10.1016/j.jsxm.2019.05.004
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Patil,CrystalL
中科院分区：
文献类型：
--
作者：
Schlaeger,JudithM;Pauls,HeatherA;Powell-Roach,KeeshaL;Thornton,PatrickD;Hartmann,Dee;Suarez,MarieL;Kobak,WilliamH;Hughes,TondaL;Steffen,AlanaD;Patil,CrystalL
背景外阴痛是一种慢性疼痛疾病，女性会经历外阴疼痛和性交困难。很少有研究探讨的范围和组合的治疗策略，妇女实际上使用，以减少vulvodynia.AimTo描述疼痛的经验和疼痛缓解策略的妇女vulvodynia.MethodsConvenience样本，60名妇女vulvodynia（中位年龄32.5 [四分位距{IQR} 8.5]岁; 50名白色，10名种族/少数民族）完成了PAINReportIt，报告了药物和酒精的使用情况，并回答了开放式问题。单变量描述性统计和双变量推断性检验用于描述平均疼痛强度评分、饮酒、吸烟、疼痛缓解策略的数量及其相关性。妇女的开放式反应，他们的疼痛经验和药物和非药物止痛策略（NDPRS）进行了分析patterns.OutcomesOur混合方法分析连接数据疼痛措施，规定的治疗和自我报告的行为与妇女的自由反应。这使妇女的外阴痛疼痛experiences.ResultsWomen的描述，他们的疼痛和痛苦与他们报告的严重疼痛，并试图控制他们的疼痛，尽管使用辅助药物（中位数2.0 [IQR 2.0]）和阿片类药物（中位数1.0 [IQR 2.0]）的中位疼痛强度为6.7（IQR 2.0）。36名女性（60%）使用酒精来减轻疼痛。26名女性（43%）列出了联合使用镇痛药和酒精来缓解疼痛。30名妇女（50%）吸烟。54名女性（90%）使用了≥1个NDPRS。使用的NDPRS的平均数量为2.1 ± 1.3（范围0-6）。女性评论中最常见的5种NDPRS是草药（40%）、针灸（27%）、按摩（22%）、催眠（15%）和心理保健（13%）。临床意义外阴痛女性的剧烈疼痛可能是那些将处方止痛药与酒精结合的风险较高的临床指标，这些都是中枢神经系统抑制剂，可能会加强过量。优势和局限性这项试点研究表明，混合方法的方法，以帮助了解外阴疼痛的复杂性是可行的。我们确定的数据显示，依赖于高风险的处方和酒精的组合，以减少外阴疼痛和吸烟的高患病率。然而，作为试点研究，这些结果被认为是初步的;样本可能不具有代表性。也许只有妇女在极端结束的疼痛连续参加，或妇女参加了调查两次，因为标识符没有collected.ConclusionDespite试图减少疼痛使用多种疗法，包括酒精，妇女的外阴疼痛是严重的，不受控制。
BackgroundWomen with vulvodynia, a chronic pain condition, experience vulvar pain and dyspareunia. Few studies examine the range and combination of treatment strategies that women are actually using to reduce vulvodynia.AimTo describe pain experiences and pain relief strategies of women with vulvodynia.MethodsConvenience sample, 60 women with vulvodynia (median age 32.5 [interquartile range {IQR} 8.5] years; 50 white, 10 racial/ethnic minorities) completed PAINReportIt and reported use of drugs and alcohol and responded to open-ended questions. Univariate descriptive statistics and bivariate inferential tests were used to describe average pain intensity scores, alcohol use, smoking, number of pain relief strategies, and their associations. Women’s open-ended responses about their pain experiences and drug and non-drug pain relief strategies (NDPRS) were analyzed for patterns.OutcomesOur mixed methods analysis connected data from pain measures, prescribed treatments and self-reported behaviors with women’s free responses. This enabled nuanced insights into women’s vulvodynia pain experiences.ResultsWomen’s descriptions of their pain and suffering aligned with their reported severe pain and attempts to control their pain, with a median pain intensity of 6.7 (IQR 2.0) despite use of adjuvant drugs (median 2.0 [IQR 2.0]), and opioids (median 1.0 [IQR 2.0]). 36 women (60%) used alcohol to lessen their pain. 26 women (43%) listed combining analgesics and alcohol to relieve their pain. 30 women (50%) smoked cigarettes. 54 women (90%) used ≥1 NDPRS. The mean number of NDPRS used was 2.1 ± 1.3 (range 0–6). The 5 most common NDPRS from women’s comments were herbal medicine (40%), acupuncture (27%), massage (22%), hypnosis (15%), and mental healthcare (13%).Clinical ImplicationsSevere pain in women with vulvodynia may be a clinical indicator of those at higher risk of combining prescription pain medications with alcohol, which are all central nervous system depressants and may potentiate overdose.Strengths and LimitationsThis pilot study demonstrated that the mixed methods approach to help understand the complexity of vulvodynia was feasible. We identified data showing a reliance on a high-risk mix of prescriptions and alcohol to reduce vulvodynia pain and a high prevalence of cigarette smoking. However, as a pilot study, these results are considered preliminary; the sample may not be representative. Perhaps only women at the extreme end of the pain continuum participated, or women took the survey twice because identifiers were not collected.ConclusionDespite attempts to reduce pain using multiple therapies, including alcohol, women’s vulvodynia pain is severe and not controlled.