Common Modalities of Pain Management in the Rural Populations of the Northwest

The purpose of this project is to identify the most common methods of pain relief for chronic low back pain in a rural northwest. Outcome indicators provide a description of the survey respondents, how pain affects their everyday life (PEG Pain Tool) and the resources they use. The quantitative and semi-structured questions added for this project provide insights into the needs of specific cohorts of patients. Population Sample A total of 133 survey responses were returned. After four were discarded (three were duplicates; one indicated experiencing acute, not chronic pain), 129 surveys were retained in the final sample, A chi-square indicated no statistical association between PEG Scoring and whether a respondent used a single provider, multiple providers or saw no provider for pain care (Chi-square = 5.040, p = 0.282). Ibuprofen was the most common medication reported with 72 (59.59%) respondents. Naproxen with 22 (18.8%) and Meloxicam 8 (6.61%) were also reported.More than 60% (n=82, 63.6%) of respondents used NSAIDs while less than one fourth of respondents used an opioid (n=30; 23.3%). A combination of NSAID and Opioid was used by 17 (13.2%) respondents. There is a strong statistical association between PEG Score and medication used when considering the use of no medication, an opioid medication or other medication(s) that does not include use of an opioid (Chi-square=18.952, p= 0.001). A strong statistical association between PEG Score and self efficacy exists, as described within participant’s stories. Participants’ who have a Severe PEG Score were much more likely to write a story reflecting negative self-efficacy (Fisher Freeman Halton = 17.952, p=0.001). Response stories written by participants with a Mild or Moderate PEG Score were more likely to reflect positive self efficacy. There is a strong statistical association between the use of activity as a management strategy, using other strategies or not engaging in management strategies (Chi-square = 18.967, p = 0.001). . Participants’ who have a Severe PEG Score were much more likely to write a story reflecting negative self-efficacy (Fisher Freeman Halton = 17.952, p=0.001). There is a strong statistical association between the use of activity as a management strategy, using other strategies or not engaging in management strategies (Chi-square = 18.967, p = 0.001).本研究旨在明确西北部农村地区慢性下腰痛最常用的镇痛方法。结局指标（Outcome indicators）用于描述调查受访者的基本特征、疼痛对其日常生活的影响（PEG疼痛量表（PEG Pain Tool））以及受访者所采用的镇痛资源。本研究增设的定量与半结构化问卷，可为特定患者队列的临床需求提供分析视角。研究人群样本：共回收133份问卷。经剔除4份无效问卷后，最终有效样本为129份：其中3份为重复问卷，1份受访者报告为急性而非慢性疼痛。卡方检验（Chi-square）结果显示，PEG评分（PEG Scoring）与受访者是否仅寻求单一镇痛医疗服务提供者、多名镇痛医疗服务提供者或未寻求任何镇痛医疗服务之间无统计学关联（卡方值=5.040，p=0.282）。布洛芬（Ibuprofen）是报告使用率最高的镇痛药物，共有72名（59.59%）受访者使用。萘普生（Naproxen）与美洛昔康（Meloxicam）的报告使用率分别为22名（18.8%）与8名（6.61%）。超过60%的受访者（n=82，63.6%）使用了非甾体抗炎药（NSAIDs），而仅不到四分之一的受访者使用了阿片类药物（n=30，23.3%）。另有17名（13.2%）受访者联合使用了非甾体抗炎药与阿片类药物。当将用药情况划分为未用药、使用阿片类药物或使用非阿片类其他药物时，卡方检验显示PEG评分与用药类型之间存在显著统计学关联（卡方值=18.952，p=0.001）。正如受访者的自述内容所示，PEG评分与自我效能感（self efficacy）之间同样存在显著统计学关联。PEG评分较高（重度）的受访者更倾向于在自述中体现出消极的自我效能感（费希尔-弗里曼-霍尔顿检验（Fisher Freeman Halton）=17.952，p=0.001）。而PEG评分为轻度或中度的受访者所撰写的自述内容，则更倾向于体现出积极的自我效能感。此外，将镇痛管理策略分为活动干预、其他策略或未采取任何管理策略时，卡方检验显示三者与PEG评分之间存在显著统计学关联（卡方值=18.967，p=0.001）。PEG评分较高（重度）的受访者更倾向于在自述中体现出消极的自我效能感（费希尔-弗里曼-霍尔顿检验=17.952，p=0.001）。将镇痛管理策略分为活动干预、其他策略或未采取任何管理策略时，卡方检验显示三者与PEG评分之间存在显著统计学关联（卡方值=18.967，p=0.001）。