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慢性疼痛患者的跨学科康复中是否需要纳入精神关怀?探索一种创新策略。

Is There a Need for Including Spiritual Care in Interdisciplinary Rehabilitation of Chronic Pain Patients? Investigating an Innovative Strategy.

作者信息

Garschagen Alexander, Steegers Monique A H, van Bergen Alfonsus H M M, Jochijms Johannes A M, Skrabanja Titus L M, Vrijhoef Hubertus J M, Smeets Rob J E M, Vissers Kris C P

机构信息

Ciran Rehabilitation Centers, Venlo, the Netherlands.

Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

出版信息

Pain Pract. 2015 Sep;15(7):671-87. doi: 10.1111/papr.12234. Epub 2014 Sep 17.

Abstract

OBJECTIVE

Chronic noncancer pain influences patient's quality of life and their ability to cope. Pain relieving medication and other specific treatments commonly integrated in biopsychosocial rehabilitation demonstrate modest benefits in pain relief and improved functioning of individuals. Spiritual care, covering the fourth dimension provides insight, inspires hope and purpose, and is thought to mediate mental and physical health for patients. This study explores the need for its inclusion in interdisciplinary pain rehabilitation and describes the requirements and test environment for evaluation.

METHODS

Outcomes of spiritual care and interdisciplinary pain rehabilitation in follow-up studies of randomized controlled trials contained in systematic reviews were summarized. Pubmed, Cochrane, and PsycINFO were searched, citation tracking was applied, articles of follow-up studies therein were located. Literature was searched for insights pertaining to requirements for an assessment of including this fourth dimension.

RESULTS

No systematic reviews for spiritual care were identified. Five systematic reviews of biopsychosocial rehabilitation containing 14 studies describing long-term outcomes were retrieved. The importance of coping in maintaining long-term outcomes was empirically illustrated. The required test environment is provided by a structured multidimensional care pathway separating spirituality from well-being and mental health, with measures of treatment outcome installed enabling a comparison with benchmarks.

CONCLUSIONS

Active coping seems beneficial for maintaining positive long-term outcomes of interdisciplinary pain rehabilitation Spiritual care may be conducive to active coping. Further research is warranted to explore the additive value of this spiritual care in the context of a multidimensional care pathway.

摘要

目的

慢性非癌性疼痛会影响患者的生活质量及其应对能力。通常纳入生物心理社会康复的止痛药物和其他特定治疗在缓解疼痛和改善个体功能方面显示出一定益处。涵盖第四维度的精神关怀能提供洞察力、激发希望和目标,并被认为可调节患者的身心健康。本研究探讨将其纳入跨学科疼痛康复的必要性,并描述评估的要求和测试环境。

方法

总结系统评价中随机对照试验随访研究中精神关怀和跨学科疼痛康复的结果。检索了PubMed、Cochrane和PsycINFO,应用了引文跟踪,找到了其中随访研究的文章。检索文献以获取有关纳入这第四维度评估要求的见解。

结果

未找到关于精神关怀的系统评价。检索到五项关于生物心理社会康复的系统评价,其中包含14项描述长期结果的研究。通过实证说明了应对在维持长期结果中的重要性。所需的测试环境由一条结构化的多维护理路径提供,该路径将精神性与幸福感和心理健康区分开来,并设置了治疗结果测量指标,以便与基准进行比较。

结论

积极应对似乎有利于维持跨学科疼痛康复的积极长期结果。精神关怀可能有助于积极应对。有必要进行进一步研究,以探索在多维护理路径背景下这种精神关怀的附加价值。

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