Management of Post Operative Pain in Underserved Populations

服务不足人群的术后疼痛管理

• 批准号: 8264141
• 负责人: Zeev Kain
• 金额: $ 15.55万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8264141
• 关键词: Adenoidectomy; Adult; African American; Age; Ambulatory Surgical Procedures; Analgesics; Area; California; Child; Childhood; Collaborations; Communities; Data; Development; Ethnic Origin; Event; Exploratory/Developmental Grant; Face; Family Characteristics; Focus Groups; Goals; Health; Health Personnel; Healthcare; Hispanics; Home environment; Hospitals; ImProv; Individual; Institute of Medicine (U.S.); Intervention; Investigation; Laboratories; Latino; Literature; Methods; Operative Surgical Procedures; Outcome; Outpatients; Pain; Pain management; Parents; Patients; Pediatric Surgical Procedures; Perception; Population; Postoperative Pain; Process; Qualitative Methods; Reporting; Research; Research Priority; Role; Series; Source; Study models; System; Techniques; Testing; Time; Tonsillectomy; Training; Underserved Population; United States; Vulnerable Populations; Work; age group; age related; base; biopsychosocial; design; ethnic difference; experience; falls; follow-up; health organization; improved; inner city; low socioeconomic status; novel; therapy development

DESCRIPTION (provided by applicant): Of the over five million children who undergo surgery in the United States, it is estimated that up to 65% will experience significant pain while in hospital and later at home. Over the past decade outpatient surgery has become much more prevalent and as a result the burden of managing postoperative pain at home falls mostly on the parents. Unfortunately, a number of studies by our laboratory as well as others indicate that many children's pain after surgery is significantly undertreated in home settings. Understanding the role of ethnicity and culture in the experience of postoperative pain at home settings is of particular importance when one considers that nearly 25% of children under the age of 5 in the United States are Hispanic. In adults, the existence of ethnic differences in perception, assessment, and treatment across settings and types of pain is well established. Indeed, the Institute of Medicine has recommended that the investigation of the sources of ethnic disparities in pain management and potential intervention strategies be a research priority. At the current time there is significant paucity of studies or interventions in this area in children. Our laboratry has demonstrated that parents of children of Hispanic origin with low socioeconomic status (SES) are significantly more likely to have misconceptions about pain management and after undergoing surgery these children are significantly more likely to receive less analgesics while at home. As a next step, we submit the need to understand the barriers for pain management in this unique population and next develop a specific intervention. The goal of this R21 application is to identify barriers to postoperative pain management in children of Hispanic origin of low SES. The study will employ both quantitative and qualitative approaches. In a follow up R01 investigation, we plan to develop and test a tailored intervention that will be directed at this underserved population. PUBLIC HEALTH RELEVANCE: At the conclusion of the study, we will have identified specific barriers to pain management at home in an underserved population. Additionally, this information will allow us to develop a data-driven intervention that will improv the present disparity in pain management of Hispanic children at home. PUBLIC HEALTH RELEVANCE: The present study seeks to identify the sources of ethnic disparities in pain management after surgery among children of Hispanic origin of low SES. Understanding potential barriers (i.e., misconceptions, miscommunication, cultural values) will allow us to develop in a follow up application an innovative, evidence- based, culturally-tailored intervention that will address these barriers to successful pain management.

描述（由申请人提供）：在美国接受手术的超过500万儿童中，据估计，在医院和后来在家里，多达65％的儿童将遭受重大疼痛。在过去的十年中，门诊手术变得越来越普遍，因此，在家管理术后疼痛的负担主要落在父母身上。不幸的是，我们的实验室以及其他研究的许多研究表明，在家庭环境中，许多儿童的疼痛都大大不足。当人们认为近25％的5岁以下儿童在美国是西班牙裔时，了解种族和文化在家庭环境中术后疼痛的作用尤为重要。在成年人中，已经建立了各种环境和类型的感知，评估和治疗的种族差异。确实，医学研究所建议对疼痛管理和潜在干预策略中种族差异的来源进行调查是研究的重点。目前，该领域的儿童研究或干预措施很少。我们的劳动力表明，具有低社会经济地位（SES）的西班牙裔子女的父母对疼痛管理有误解的可能性更大，并且在接受手术后，这些孩子在家里的镇痛药更少的可能性更大。下一步，我们提出需要了解这个独特人群中疼痛管理的障碍，并下一步制定特定的干预措施。该R21应用程序的目的是确定低SES西班牙裔儿童术后疼痛管理的障碍。该研究将采用定量和定性方法。在随访的R01调查中，我们计划开发和测试定制的干预措施，该干预措施将针对该服务不足的人群。公共卫生相关性：在研究结束时，我们将在服务不足的人群中确定家里疼痛管理的特定障碍。此外，这些信息将使我们能够开发以数据为基础的干预措施，从而改善家庭中西班牙裔儿童疼痛管理的当前差异。 公共卫生相关性：本研究旨在确定低SES的西班牙裔儿童手术后疼痛管理中种族差异的根源。了解潜在的障碍（即误解，误解，文化价值）将使我们能够在后续应用中发展一种创新的，基于证据的，具有文化范围的干预措施，将解决这些成功的疼痛管理的障碍。