Panel-based pain management in primary care: A pilot study
Panel-based pain management in primary care: A pilot study
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DOI：
10.1016/s0885-3924(01)00301-3
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发表时间：
2001-07-01
影响因子：
4.7
通讯作者：
Stukel, TA
中科院分区：
文献类型：
--
作者：
Ahles, TA;Seville, J;Stukel, TA
虽然疼痛是一个非常常见的症状，提出了初级保健医生，它往往不是最佳的管理。这项可行性研究的目的是开发和试点测试一个有效的，快速的评估和管理方法的疼痛在忙碌社区的做法。干预利用达特茅斯合作临床改进系统（DCCIS）和电话为基础的，护士教育干预。来自新罕布什尔州和佛蒙特州农村的四个初级保健实践的患者通过邮件筛选持续性疼痛的存在。轻度至重度疼痛患者随机分为常规护理对照组（n=383）或干预组（n=320）。报告疼痛但无心理社会问题的患者通过邮件（DCCIS）收到了已确定问题的摘要和有针对性的教育材料。报告疼痛和心理社会问题的患者接受了DCCIS干预，并从护士教育者那里获得了疼痛自我管理策略和解决心理社会问题的方法。治疗后评估显示，与常规护理对照组相比，干预组患者在SF-36的疼痛、身体、情感和社会子量表以及功能性干扰量表总分上的得分显著更好。证明了该方法的可行性和可接受性;然而，基于治疗后结局分析的结论受到各组基线不平衡的影响。疼痛症状管理杂志2001;22：584-590. (C)美国癌症疼痛缓解委员会，2001年。
Although pain is an extremely common symptom presenting to primary care physicians, it frequently is not optimally managed. The purpose of this feasibility study was to develop and pilot-test an efficient, rapid assessment and management approach for pain in busy community practices. The intervention utilized the Dartmouth COOP clinical Improvement System (DCCIS) and a telephone-based, nurse-educator intervention. Patients from four primary care practices in rural New Hampshire and Vermont were screened by mail for the presence of persistent pain. Patients with mild to severe pain were randomized to either the usual care control group (n=383) or the intervention group (n=320). Patients who reported pain but no psychosocial problems received a summary of identified problems and targeted educational material via mail (DCCIS). Patients who reported pain and psychosocial problems received the DCCIS intervention and calls from a nurse-educator who provided pain self-management strategies and a problem-solving approach for psychosocial problems. Post-treatment evaluation revealed that patients in the intervention group scored significantly better on the Pain, Physical, Emotional, and Social subscales of the SF-36 and on the total score of the Functional Interference Scale, as compared to a usual care control group. Feasibility and acceptability of the approach were demonstrated; however, the conclusions based on analyses of the post-treatment outcomes were tempered by baseline imbalances across groups. J Pain Symptom Manage 2001;22:584-590. (C) U.S. Cancer Pain Relief Committee, 2001.