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首页> 外文学位 >The family physician experience of treating chronic pain patients whose pain has complex etiology: A qualitative study.
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The family physician experience of treating chronic pain patients whose pain has complex etiology: A qualitative study.

机译：家庭医生治疗病因复杂的慢性疼痛患者的经验：定性研究。

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The goal of this project was to understand the family physician experience of working with chronic pain patients whose pain has complex etiology. The long-range research purpose was to discover the components of the physician-chronic pain patient relationship that could serve as the basis of future research projects predicting effective clinical interventions. These more successful treatments could be the basis of future physician training courses.; This qualitative research project was conducted by interviewing 11 physicians from 8 states. The interview guide directed physicians to describe problematic cases compared to more successful cases. Physicians discussed diagnoses, treatments, personal expertise, professional issues, patient relationship concerns, goals and expectations, physician and patient reactions, psychosocial factors, and referrals.; The only beneficial treatments mentioned by all physicians were physical therapy, anti-depressants, and counseling. Four main themes were the most frequently discussed: (a) the significance of the multifactorial nature of chronic pain, (b) the importance of understanding opioids and addiction issues in the treatment of chronic pain, (c) the creation of an effective working partnership between physician and patient, and (d) the significance of helping patients refocus their goals from pain elimination to daily functioning and adaptation.; The results of this study were compared to previous findings reported in the literature and confirmed the importance of the following themes: (a) consideration of psychosocial factors and a multidisciplinary approach when working with chronic pain patients; (b) maintenance of an effective physician-patient relationship where the physician is sensitive to the patient perspective; (c) understanding the foundations of relationship problems such as patient psychiatric co-morbidity; and (d) physician awareness of, and ability to cope with, his or her own negative reactions to certain chronic pain situations.; Several themes were stressed in the literature but not in the research: (a) the importance of the physicians' ability to analyze their own reactions to chronic pain patient experiences, and (b) the significance of the physicians' willingness to use support systems when coping with these problematic personal reactions. Themes that were stressed in the research but not in the literature were: (a) the problematic nature of opioid usage in chronic pain situations, (b) the contrasting goals of pain elimination versus adaptation and functioning, and (c) the patient tendency to deny psychosocial aspects of chronic pain. Ideas for future research projects are outlined. For example, valuable studies would determine methods by which to educate (a) physicians about the importance of self-analysis, and (b) chronic pain patients about the significance of the psychosocial components of chronic pain.
机译：该项目的目的是了解家庭医生与病因复杂的慢性疼痛患者一起工作的经验。长期研究的目的是发现医师与慢性疼痛患者之间的关系，这些组分可以作为预测有效临床干预措施的未来研究项目的基础。这些更成功的治疗方法可能会成为未来医师培训课程的基础。该定性研究项目是通过采访来自8个州的11位医生而进行的。访谈指南指示医生与较成功的案例相比，描述有问题的案例。医师讨论了诊断，治疗，个人专长，专业问题，患者关系问题，目标和期望，医师和患者的反应，社会心理因素以及转诊。所有医生提到的唯一有益的治疗方法是物理治疗，抗抑郁药和咨询。最经常讨论的四个主题是：（a）慢性疼痛的多因素性质的重要性;（b）了解阿片类药物和成瘾问题在治疗慢性疼痛中的重要性;（c）建立有效的工作伙伴关系在医师和患者之间，以及（d）帮助患者重新确定其目标从消除疼痛到日常功能和适应的重要性。这项研究的结果与文献中先前报道的发现进行了比较，并证实了以下主题的重要性：（a）考虑慢性病患者时的社会心理因素和多学科方法; （b）在医师对患者观点敏感的情况下维持有效的医患关系; （c）了解诸如患者精神病合并症等关系问题的基础; （d）医生对某些慢性疼痛情况的不良反应的认识和应对能力;文献中强调了几个主题，但研究中没有强调：（a）医生分析自己对慢性疼痛患者经历的反应能力的重要性，以及（b）医师愿意在支持时使用支持系统的重要性应对这些有问题的个人反应。该研究中强调但没有文献强调的主题是：（a）在慢性疼痛情况下使用阿片类药物的问题性质;（b）消除疼痛与适应和功能相反的目标;以及（c）患者倾向于否认慢性疼痛的社会心理方面。概述了未来研究项目的想法。例如，有价值的研究将确定教育（a）医师关于自我分析的重要性和（b）慢性疼痛患者关于慢性疼痛的社会心理成分的重要性的方法。

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