Experiences and perspectives of adults on using opioids for pain management in the postoperative period: A scoping review.

IF 4.2 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Anaesthesiology Pub Date : 2024-07-01 Epub Date: 2024-05-16 DOI:10.1097/EJA.0000000000002002
Dalia M Aljohani, Nabat Almalki, Diane Dixon, Rosalind Adam, Patrice Forget
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引用次数: 0

Abstract

Background: Opioids play an important role in peri-operative pain management. However, opioid use is challenging for healthcare practitioners and patients because of concerns related to opioid crises, addiction and side effects.

Objective: This review aimed to identify and synthesise the existing evidence related to adults' experiences of opioid use in postoperative pain management.

Design: Systematic scoping review of qualitative studies. Inductive content analysis and the Theoretical Domains Framework (TDF) were applied to analyse and report the findings and to identify unexplored gaps in the literature.

Data sources: Ovid MEDLINE, PsycInfo, Embase, CINAHL (EBSCO), Cochrane Library and Google Scholar.

Eligibility criteria: All qualitative and mixed-method studies, in English, that not only used a qualitative approach that explored adults' opinions or concerns about opioids and/or opioid reduction, and adults' experience related to opioid use for postoperative pain control, including satisfaction, but also aspects of overall quality of a person's life (physical, mental and social well being).

Results: Ten studies were included; nine were qualitative ( n  = 9) and one used mixed methods. The studies were primarily conducted in Europe and North America. Concerns about opioid dependence, adverse effects, stigmatisation, gender roles, trust and shared decision-making between clinicians and patients appeared repeatedly throughout the studies. The TDF analysis showed that many peri-operative factors formed people's perceptions and experiences of opioids, driven by the following eight domains: Knowledge, Emotion, Beliefs about consequences, Beliefs about capabilities, Self-confidence, Environmental Context and Resources, Social influences and Decision Processes/Goals. Adults have diverse pain management goals, which can be categorised as proactive and positive goals, such as individualised pain management care, as well as avoidance goals, aimed at sidestepping issues such as addiction and opioid-related side effects.

Conclusion: It is desirable to understand the complexity of adults' experiences of pain management especially with opioid use and to support adults in achieving their pain management goals by implementing an individualised approach, effective communication and patient-clinician relationships. However, there is a dearth of studies that examine patients' experiences of postoperative opioid use and their involvement in opioid usage decision-making. A summary is provided regarding adults' experiences of peri-operative opioid use, which may inform future researchers, healthcare providers and guideline development by considering these factors when improving patient care and experiences.

成人在术后使用阿片类药物止痛的经验和观点:范围综述。
背景:阿片类药物在围手术期疼痛治疗中发挥着重要作用。然而,由于对阿片类药物危机、成瘾和副作用的担忧,阿片类药物的使用对医护人员和患者来说具有挑战性:本综述旨在确定和综合与成人在术后疼痛治疗中使用阿片类药物的经验有关的现有证据:设计:对定性研究进行系统的范围界定。采用归纳式内容分析和理论领域框架(TDF)来分析和报告研究结果,并找出文献中尚未探索的空白点:数据来源:Ovid MEDLINE、PsycInfo、Embase、CINAHL (EBSCO)、Cochrane Library 和 Google Scholar:所有定性和混合方法的英文研究,这些研究不仅采用定性方法探讨成人对阿片类药物和/或减少阿片类药物的意见或担忧,以及成人使用阿片类药物控制术后疼痛的相关经验,包括满意度,还包括个人整体生活质量的各个方面(身体、精神和社会福利):共纳入十项研究,其中九项为定性研究(n = 9),一项采用混合方法。这些研究主要在欧洲和北美进行。在这些研究中,有关阿片类药物依赖性、不良影响、污名化、性别角色、临床医生与患者之间的信任和共同决策等问题反复出现。TDF 分析表明,许多围手术期因素形成了人们对阿片类药物的认知和体验,这些因素由以下八个领域驱动:知识、情感、对后果的信念、对能力的信念、自信、环境背景和资源、社会影响和决策过程/目标。成人有不同的疼痛管理目标,可分为主动和积极的目标,如个性化疼痛管理护理,以及避免目标,旨在回避成瘾和阿片类药物相关副作用等问题:了解成年人疼痛管理(尤其是使用阿片类药物)经历的复杂性,并通过实施个性化方法、有效沟通和病人与医生的关系来支持成年人实现其疼痛管理目标,是非常可取的。然而,有关患者术后使用阿片类药物的经历及其参与阿片类药物使用决策的研究却十分匮乏。本文总结了成人围手术期使用阿片类药物的经验,在改善患者护理和经验时考虑到这些因素,从而为未来的研究人员、医疗服务提供者和指南制定提供参考。
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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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