Self-management of chronic pain: a population-based study
Self-management of chronic pain: a population-based study
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DOI：
10.1016/j.pain.2004.12.004
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发表时间：
2005-02-01
期刊：
影响因子：
7.4
通讯作者：
Cousins, MJ
中科院分区：
文献类型：
--
作者：
Blyth, FM;March, LM;Cousins, MJ
虽然慢性疼痛的有效自我管理很重要，但基于临床的研究排除了社区中发生的更典型的自我管理模式，通常没有参考卫生专业人员。我们在一项针对慢性疼痛受试者的基于人群的研究中检验了有关使用自我管理策略的具体假设。数据来自一项基于澳大利亚人口的随机数字拨号计算机辅助电话调查，包括 474 名 18 岁或以上患有慢性疼痛的成年人（答复率为 73.4%）。被动策略比主动策略更常见：最常见的是服用药物（47%）、休息（31.5%）和使用热/冷袋（23.4%）等被动策略，而最常见的主动策略是锻炼（25.8%）。在使用主动行为和/或认知策略的人中，只有 33.5% 只使用这些策略，而在使用被动行为和/或传统医疗策略的人中，67.7% 只使用这些策略。在多重逻辑回归模型中，自我管理策略与疼痛相关的残疾和卫生服务的使用相关。使用被动策略增加了患有高水平疼痛相关残疾的可能性（调整后 OR 2.59）和更多与疼痛相关的医疗保健就诊（调整后 OR 2.9）；使用积极的策略大大降低了患有高水平疼痛相关残疾的可能性（调整后的 OR 0.2）。总之，我们在一项基于人群的研究中表明，有关自我管理策略的临床发现适用于更广泛的人群，并主张更多地关注基于社区的策略，以提高对慢性疼痛的积极自我管理策略的认识和采用。 (C) 2004 年国际疼痛研究协会。由 Elsevier B.V. 出版。保留所有权利。
While effective self-management of chronic pain is important, clinic-based studies exclude the more typical pattern of self-management that occurs in the community, often without reference to health professionals. We examined specific hypotheses about the use of self-management strategies in a population-based study of chronic pain subjects. Data came from an Australian population-based random digit dialling computer-assisted telephone survey and included 474 adults aged 18 or over with chronic pain (response rate 73.4%). Passive strategies were more often reported than active ones: passive strategies such as taking medication (47%), resting (31.5%), and using hot/cold packs (23.4%) were most commonly reported, while the most commonly reported active strategy was exercising (25.8%). Only 33.5% of those who used active behavioural and/or cognitive strategies used them exclusively, while 67.7% of those who used passive behavioural and/or conventional medical strategies did so exclusively. Self-management strategies were associated with both pain-related disability and use of health services in multiple logistic regression models. Using passive strategies increased the likelihood of having high levels of pain-related disability (adjusted OR 2.59) and more pain-related health care visits (adjusted OR 2.9); using active strategies substantially reduced the likelihood of having high levels of pain-related disability (adjusted OR 0.2). In conclusion, we have shown in a population-based study that clinical findings regarding self-management strategies apply to the broader population and advocate that more attention be given to community-based strategies for improving awareness and uptake of active self-management strategies for chronic pain. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.