风湿病相关的疼痛和对策.ppt

* * * The goals of therapy for acute pain differ from those for chronic pain. The goal of therapy for acute pain is to remove the cause of pain. When pain is inevitable, for example, postoperative pain and trauma, treatment focuses on quick and effective analgesia.1 Goals of therapy for certain types of chronic pain, including arthritis, are to recognize the incurability of the underlying disease process and to focus on quality of life by reducing pain, maintaining and/or improving mobility, and limiting functional impairment.2 Fields HL, Martin JB. Pain: pathophysiology and management. In: Fauci AS, Braunwald E, Isselbacher KF, et al, eds. Harrison’s Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:53-58. Marcus DA. Treatment of nonmalignant chronic pain. Am Fam Physician. 2000;61:1331-1338. * The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has revised its standards on pain management.1 Appropriate management of pain is essential for maintaining patient health and quality of life. However, the subjective nature of pain, confusion as to who is responsible for treating it, a lack of understanding of pain, and misconceptions about drug addiction and tolerance make pain management difficult.2 The 2001 standards focus on issues of patients’ rights, education, and training; on the quantification of pain; and on the systematic assessment and safe management of pain.2 The standards emphasize that1 Patients have certain rights regarding assessment and management of their pain Pain is to be assessed in all patients The goal of patient care is to provide individualized care in settings responsive to specific patient needs have policies and procedures in place that support safe medication prescription and ordering monitor patients during the postprocedure period Rehabilitation is designed to achieve an optimal level of functioning, self-care, self-responsibility, independence, and quality of life minimize symptoms and