Smoking cessation and chronic pain: patient and pain medicine physician attitudes.
Smoking cessation and chronic pain: patient and pain medicine physician attitudes.
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DOI：
10.1111/j.1533-2500.2011.00462.x
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发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Warner DO
中科院分区：
文献类型：
--
作者：
Hooten WM;Vickers KS;Shi Y;Ebnet KL;Townsend CO;Patten CA;Warner DO
尽管先前的研究表明，跨学科疼痛治疗项目的临床环境可能为促进戒烟提供了一个最佳环境，但目前可用的戒烟干预措施对慢性疼痛成年人可能效果欠佳，部分原因是与慢性疼痛相关的临床因素未被识别。这项定性研究的具体目的是从参与跨学科疼痛治疗项目的慢性疼痛成年吸烟者那里获取信息，了解他们对吸烟如何影响疼痛症状的看法，以及这些信念、认知和情绪如何阻碍或促进戒烟。从一组疼痛专科医生那里也获取了类似信息。该研究涉及18名慢性疼痛吸烟者和7名医生。患者报告称，吸烟是应对疼痛和痛苦的重要策略，主要是分别提供了分散注意力和逃避的机会。大多数使用阿片类药物的患者报告称，阿片类药物的使用会刺激吸烟。在疼痛治疗期间尝试戒烟的重要障碍被确定，包括在改变阿片类药物使用的同时戒烟，以及应对多种与治疗相关的压力源的感知困难。医生确定了戒烟对疼痛的一些相关益处，但也认识到提供戒烟服务的重要障碍，包括缺乏时间以及关于如何帮助患者戒烟的知识。这项研究的结果确定了几个新的重要临床因素，这些因素应纳入针对慢性疼痛成年人的有针对性的戒烟干预措施中。
Although previous studies suggest that the clinical setting of an interdisciplinary pain treatment program may provide an optimal environment to promote smoking cessation, currently available smoking cessation interventions may be less effective for adults with chronic pain due, in part, to unrecognized clinical factors related to chronic pain. The specific aim of this qualitative study was to solicit information from adult smokers with chronic pain participating in an interdisciplinary pain treatment program regarding their perceptions of how smoking affects pain symptoms, and how these beliefs, cognitions, and emotions may either impede or facilitate smoking cessation. Similar information was solicited from a group of pain specialty physicians. The study involved 18 smokers with chronic pain, and seven physicians. Patients reported that smoking was an important coping strategy for pain and distress, primarily by offering an opportunity for distraction and avoidance, respectively. The majority of patients using opioids reported that opioid consumption stimulated smoking. Important barriers were identified toward making a quit attempt during pain treatment including quitting smoking while making changes in opioid use, and perceived difficulty managing multiple treatment-related stressors. Several pain-related benefits of smoking cessation were identified by physicians, but important barriers to providing smoking cessation services were recognized including lack of time and knowledge about how to help patients quit smoking. The findings of this study identified several novel and important clinical factors that should be incorporated into a targeted smoking cessation intervention for adults with chronic pain.
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