Women Veterans' Experiences with Integrated, Biopsychosocial Pain Care: A Qualitative Study.
Women Veterans' Experiences with Integrated, Biopsychosocial Pain Care: A Qualitative Study.
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女性退伍军人综合生物心理社会疼痛护理的经验：一项定性研究。
DOI：
10.1093/pm/pnaa481
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Seal,KarenH
中科院分区：
文献类型：
--
作者：
Nicosia,FrancescaM;Gibson,CarolynJ;Purcell,Natalie;Zamora,Kara;Tighe,Jennifer;Seal,KarenH
目的为了改善慢性疼痛护理和减少与阿片类药物相关的风险，生物心理社会综合疼痛护理模式在退伍军人健康管理局得到了越来越多的应用，但这些模式如何更好地满足女性退伍军人的需求知之甚少。设计基于访谈的定性研究。建立旧金山VA卫生保健系统综合疼痛护理团队(IPT)，一个跨学科团队，提供短期的、个性化的慢性疼痛护理，强调功能目标和积极的自我管理。受试者患有慢性疼痛，完成了≥3 IPT课程。方法半结构化电话访谈集中于综合疼痛护理的整体体验、感知的IPT护理效果、疼痛护理偏好以及改善性别敏感疼痛护理的建议改变。结果14名女性退伍军人(平均年龄51岁，年龄33-67岁)完成了访谈。访谈揭示了几个影响女性退伍军人体验的因素：1)总体上倾向于在不同性别的环境中接受初级和IPT护理，2)不同程度的信心，认为IPT可以充分解决特定性别的疼痛问题，3)参与疼痛小组的障碍，以及4)由于照顾责任的障碍，IPT自我管理建议的障碍。改善对性别敏感的疼痛护理的建议包括增加提供者培训；提高对妇女健康问题的认识和敏感性；改善对既往创伤、家庭和工作义务以及地理障碍的适应。为了更好地满足患有慢性疼痛的女性退伍军人的需求，必须通过了解特定性别的需求、挑战和偏好来了解综合疼痛护理模式。
ObjectivesBiopsychosocial, integrated pain care models are increasingly implemented in the Veterans Health Administration to improve chronic pain care and reduce opioid-related risks, but little is known about how well these models address women veterans’ needs.DesignQualitative, interview-based study.SettingSan Francisco VA Health Care System Integrated Pain Team (IPT), an interdisciplinary team that provides short-term, personalized chronic pain care emphasizing functional goals and active self-management.SubjectsWomen with chronic pain who completed ≥3 IPT sessions.MethodsSemistructured phone interviews focused on overall experience with IPT, perceived effectiveness of IPT care, pain care preferences, and suggested changes for improving gender-sensitive pain care. We used a rapid approach to qualitative thematic analysis to analyze interviews.ResultsFourteen women veterans (mean age 51 years; range 33–67 years) completed interviews. Interviews revealed several factors impacting women veterans’ experiences: 1) an overall preference for receiving both primary and IPT care in gender-specific settings, 2) varying levels of confidence that IPT could adequately address gender-specific pain issues, 3) barriers to participating in pain groups, and 4) barriers to IPT self-management recommendations due to caregiving responsibilities.ConclusionsWomen veterans reported varied experiences with IPT. Recommendations to improve gender-sensitive pain care include increased provider training; increased knowledge of and sensitivity to women’s health concerns; and improved accommodations for prior trauma, family and work obligations, and geographic barriers. To better meet the needs of women veterans with chronic pain, integrated pain care models must be informed by an understanding of gender-specific needs, challenges, and preferences.
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