Pain Treatment Practices of Community-Dwelling Black Older Adults
Pain Treatment Practices of Community-Dwelling Black Older Adults
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DOI：
10.1016/j.pmn.2017.10.009
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发表时间：
2018-02-01
影响因子：
1.7
通讯作者：
Vallerand, April Hazard
中科院分区：
文献类型：
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作者：
Robinson-Lane, Sheria G.;Vallerand, April Hazard
黑人老年人经常在疼痛治疗方面遇到差异，导致疼痛需求未得到满足。本研究的目的是评估一组社区居住的黑人老年人的疼痛管理经验，并确定临床实践中的差距。定性，描述性设计采用民族志的方法。该设置是一个城市，低收入，社区老年人住房高层设施。参与者包括设施居民（n = 106），其中，20个完成结构化定性访谈。简明疼痛量表和定性访谈被用来确定疼痛的患病率，治疗方法和障碍。86%的参与者有严重的疼痛，平均最严重的疼痛评分为7分（0到10分）。疼痛中度干扰一般活动（5.59），步行（5.73）和正常工作（5.70），也在0至10个量表上测量。参与者首选非阿片类镇痛药，局部非处方药治疗和非药物干预，如祈祷/冥想和运动治疗。参与者最常用于疼痛管理的药物包括氢可酮与对乙酰氨基酚（28.6%）、非甾体抗炎药（13.2%）、对乙酰氨基酚与可待因（12%）和曲马多（9.9%）。定性访谈显示，疼痛管理障碍集中在对副作用，成瘾的恐惧和供应商的不信任的沟通问题。患者和提供者之间存在沟通障碍。讨论患者的治疗偏好，提供平衡的治疗信息，并通过电话随访患者治疗计划的有效性，可以改善黑人老年人的疼痛管理方式。(C)美国疼痛管理护理学会（American Society for Pain Management Nursing）
Black older adults often experience disparities in pain treatment that results in unmet pain needs. The aims of this study were to assess the pain management experiences of a group of community dwelling Black older adults and identify gaps in clinical practice. A qualitative, descriptive design was employed using the methodology of ethnography. The setting was an urban, low-income, community elderly housing high-rise facility. Participants included facility residents (n = 106); of these, 20 completed structured qualitative interviews. The Brief Pain Inventory and qualitative interviews were used to determine pain prevalence, treatment practices, and barriers. Eighty-six percent of the participants had severe pain with a mean worst pain rating of 7 on a 0 to 10 scale. Pain interfered moderately with general activity (5.59), walking (5.73) and normal work (5.70), also measured on 0 to 10 scales. Participants preferred non-opioid analgesics, topical over-the-counter treatments, and nonpharmacological interventions such as prayer/meditation, and exercise for treatment. Medications most commonly used by participants for pain management included, hydrocodone with acetaminophen (28.6%), nonsteroidal anti-inflammatory drugs (13.2%), acetaminophen with codeine (12%), and tramadol (9.9). Qualitative interviews revealed that pain management barriers were centered around communication concerns about side effects, fears of addiction, and provider mistrust. A communication gap exists between patients and providers. Discussing patient treatment preferences, providing balanced treatment information, and following-up with patients on treatment plan effectiveness by phone can improve how pain is managed for Black older adults. (C) 2017 by the American Society for Pain Management Nursing