行动计划:瑞典成人慢性疼痛的医疗保健途径。

IF 1.9 Q4 CLINICAL NEUROLOGY
Scandinavian Journal of Pain Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI:10.1515/sjpain-2024-0082
Marcelo Rivano Fischer, Allan Abbott, Mathilda Björk, Gunilla Brodda Jansen, Gunilla Göran, Britt-Marie Stålnacke, Monika Löfgren
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引用次数: 0

摘要

目的:慢性疼痛是一个主要的全球公共卫生问题。在瑞典,20%的成年人报告中度至重度慢性疼痛,7%的人持续寻求医疗保健。慢性疼痛的治疗、可及性和医疗保健知识方面的不足以前有过报道。缺乏从初级到专业护理和康复的通用治疗结构。本研究旨在描述瑞典成人慢性疼痛以人为中心和连贯护理(P3C)途径的发展过程。方法:委托一个具有疼痛医学、康复医学、精神病学、麻醉学、神经外科、普通医学、护理学、心理学、物理治疗、职业治疗和患者代表等专业知识的国家行动小组,按照逐步共同设计的方法开发路径,包括绘制路径的现状、目标、措施和指标、评估后果和锚定过程。结果:目标是基于地图中确定的挑战,包括改善患者的健康状况,护理接触期间和之间的连续性,及时的自我管理,护理水平之间的沟通,以及对疼痛的了解。描述了通道入口和出口点。措施侧重于早期疼痛分析、评估和治疗的生物心理社会方法、早期康复计划、团队合作、各级护理之间的对话和联合计划、患者参与以及关于疼痛及其后果的教育等领域。包括过程和结果指标,以及关于患者利益和风险、伦理方面、成本以及该途径对医疗保健其他领域的影响的报告。结论:P3C通路解决了患者和从业人员描述的挑战。通过以人为本和连贯一致,它可以促进患者赋权和护理中的平等,重点是早期和及时的干预,患者与从业人员之间以及护理水平之间的对话,疼痛的自我管理而不是长期的医疗干预,价值驱动和协调的护理联系,以及根据现有证据和经验增加对慢性疼痛的了解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An action plan: The Swedish healthcare pathway for adults with chronic pain.

Objectives: Chronic pain is a major global public-health issue. In Sweden, 20% adults report moderate to severe chronic pain, with 7% continuously seeking healthcare. Shortcomings in treatment, accessibility, and knowledge in healthcare for chronic pain have previously been reported. A generic treatment structure from primary to specialized care and rehabilitation was missing. This study aims to describe the development process for the creation of a person-centered and coherent care (P3C) pathway for adults with chronic pain in Sweden.

Methods: A National Action Group with expertise in pain medicine, rehabilitation medicine, psychiatry, anesthesiology, neurosurgery, general medicine, nursing, psychology, physiotherapy, occupational therapy, and patient representation was commissioned to develop the pathway following a stepwise co-designed approach, which included mapping current situation, goals, measures and indicators of the pathway, assessment of consequences and anchoring the process.

Results: Goals were based on challenges identified in the mapping, including improvements in patient's well-being, continuity during and between care contacts, timely self-management, communication between levels of care, and knowledge about pain. Points of pathway entrance and exit were described. Measures focused on areas such as early pain analysis, biopsychosocial approach to assessment and treatment, early rehabilitation plan, teamwork, dialogue and joint plans between levels of care, patient participation, and education on pain and its consequences. Process and outcome indicators, and a report on benefits and risks for patients, ethical aspects, costs, and impacts of the pathway on other areas of healthcare were included.

Conclusions: The P3C pathway addressed the challenges described by patients and practitioners. By being person-centered and coherent, it can promote patient empowerment and equality in care, with emphasis on early and timely interventions, dialogue between patients and practitioners and between levels of care, self-management of pain instead of prolonged medical intervention, value-driven and coordinated care contacts, and increased knowledge about chronic pain, based on existing evidence and experience.

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来源期刊
Scandinavian Journal of Pain
Scandinavian Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.30
自引率
6.20%
发文量
73
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