Patient motivators to use opioids for acute pain after emergency care.

Patient motivators to use opioids for acute pain after emergency care.
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DOI:
10.3389/fpain.2023.1151704
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发表时间:
2023
期刊:
Frontiers in pain research (Lausanne, Switzerland)
影响因子:
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通讯作者:
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其他
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患者是自己疼痛管理的利益相关者。促使个体寻求或使用阿片类药物治疗急性疼痛的因素尚未得到很好的表征,但可以有针对性地减少医源性阿片类药物使用障碍(OUD)的发生。急诊科(ED)通常会遇到急性疼痛的患者,他们需要做出阿片类药物治疗的决定。决策是必然的挑战,在情节,不定期的护理设置给定的时间压力,有限的信息,并缺乏预先存在的患者提供者的关系。患者可能会拒绝服用处方阿片类药物,或相反地从其他提供者或非医疗来源寻求阿片类药物。使用框架分析方法,我们定性分析了29例患者出院后的成绩单艾德访视急性疼痛在美国中西部的一个大型,城市,学术医院,以描述激励因素影响患者的决策阿片类药物用于急性疼痛。一个半结构化的采访指南框架参与者的讨论,无论是焦点小组或采访转录和分析与传统的内容分析。从我们的分析中出现了四个主要主题,包括a)疼痛管理素养,B)控制偏好,c)风险承受能力和d)行动线索。我们的研究结果提出了未来干预发展的目标和一个框架,以指导患者作为利益相关者参与自己的急性疼痛管理。
Patients are stakeholders in their own pain management. Factors motivating individuals to seek or use opioids therapeutically for treatment of acute pain are not well characterized but could be targeted to reduce incident iatrogenic opioid use disorder (OUD). Emergency departments (EDs) commonly encounter patients in acute pain for whom decisions regarding opioid therapy are required. Decision-making is necessarily challenged in episodic, unscheduled care settings given time pressure, limited information, and lack of pre-existing patient provider relationship. Patients may decline to take prescribed opioids or conversely seek opioids from other providers or non-medical sources. Using a framework analysis approach, we qualitatively analyzed transcripts from 29 patients after discharge from an ED visit for acute pain at a large, urban, academic hospital in the midwestern United States to describe motivating factors influencing patient decisions regarding opioid use for acute pain. A semi-structured interview guide framed participant discussion in either a focus group or interview transcribed and analyzed with conventional content analysis. Four major themes emerged from our analysis including a) pain management literacy, b) control preferences, c) risk tolerance, and d) cues to action. Our findings suggest targets for future intervention development and a framework to guide the engagement of patients as stakeholders in their own acute pain management.
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