Patient Pain Experiences and the Emergency Department Encounter: A Qualitative Analysis.
Patient Pain Experiences and the Emergency Department Encounter: A Qualitative Analysis.
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DOI：
10.1016/j.pmn.2022.03.012
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发表时间：
2022-08
影响因子：
1.7
通讯作者：
Lyons, Michael S.
中科院分区：
文献类型：
--
作者：
Punches, Brittany E.;Brown, Jennifer L.;Soliman, Summer;Johnson, Kimberly D.;Freiermuth, Caroline E.;Walker, Quinn;Omololu, Shammah O.;Lyons, Michael S.
立法、实践建议以及治疗性阿片类药物暴露与医源性阿片类药物使用障碍 (OUD) 之间可能存在的联系导致阿片类药物处方量减少。这种变化对未缓解的疼痛和药物过量危机的影响尚不清楚。我们探讨了急诊科 (ED) 患者涉及疼痛和紧急护理的信念和经历，为未来心理社会干预措施的发展提供信息，以平衡急性疼痛管理的需求与阿片类药物暴露的风险。 2020 年 9 月至 2021 年 5 月，对 18 名出现急性疼痛的成年患者从城市学术一级创伤中心 ED 出院后进行了定性、半结构化访谈。录音转录后，使用框架分析确定了共同主题。使用皮尔逊相关系数验证主题层次，以进行单词相似性的聚类分析。在 18 名参与者中，大多数是非裔美国人（n=11，61%）和男性（n=12，66.7%）。分析确定了一个首要主题，即紧急疼痛遭遇的控制点。围绕疼痛管理的内部和外部影响确定了四个主题：1）获得急性疼痛的医疗保健； 2）控制出院后的疼痛； 3) 寻求阿片类药物：自我治疗和滥用，4) 阿片类药物危机使痛苦的人遭受痛苦。从急诊室出院的患者报告疼痛未缓解、影响疼痛管理的因素以及从非医疗来源寻求阿片类药物的能力。在疼痛管理的优先顺序和个体化护理的重要性方面，患者和提供者之间存在显着脱节。
Legislation, practice recommendations, and the likely link between therapeutic opioid exposure and iatrogenic opioid use disorder (OUD) have led to reduced opioid prescribing. The effects of this change on unrelieved pain and the overdose crisis are not well-characterized. We explored emergency department (ED) patients’ beliefs and experiences involving pain and emergency care to inform the development of future psychosocial interventions that balance the need for acute pain management with risks from opioid exposure. Qualitative, semi-structured interviews were conducted after discharge from an urban, academic Level 1 trauma center ED from September 2020 to May 2021 with 18 adult patients presenting with acute pain. After transcription of audio recording, common themes were identified using framework analysis. Thematic hierarchy was validated with Pearson correlation coefficients for cluster analysis of word similarity. Of the 18 participants, most were African American (n=11, 61%) and male (n=12, 66.7%). Analysis identified one overarching theme, Locus of control with an emergency pain encounter. Four themes were identified surrounding internal and external influences on pain management: 1) Accessing healthcare for acute pain; 2) Managing the pain after discharge; 3) Seeking opioids: self-medicating and misuse, and 4) Opioid crisis makes people in pain suffer. Patients discharged from the ED reported unrelieved pain, factors that influence their pain management, and an ability to seek opioids from non-medical sources. There is a significant disconnect between patients and providers in terms of priorities in pain management and the importance of individualized care.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1001/jama.2021.1169
发表时间：
2021-03-23
期刊：
JAMA
影响因子：
--
作者：
Baldwin GT;Seth P;Noonan RK
通讯作者：
Noonan RK
DOI：
10.1111/ejn.12414
发表时间：
2014-02
期刊：
The European journal of neuroscience
影响因子：
--
作者：
Schwaller F;Fitzgerald M
通讯作者：
Fitzgerald M
影响因子：
6.2
作者：
Jeffery, Molly Moore;Hooten, W. Michael;Bellolio, M. Fernanda
通讯作者：
Bellolio, M. Fernanda
DOI：
10.1111/add.13807
发表时间：
2017-08
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Murphy SM;Polsky D;Lee JD;Friedmann PD;Kinlock TW;Nunes EV;Bonnie RJ;Gordon M;Chen DT;Boney TY;O'Brien CP
通讯作者：
O'Brien CP