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).

本项目旨在识别美国西北部农村地区慢性腰背痛最常用的镇痛方法。本研究的结局指标用于描述调查受访者的基本情况、疼痛对其日常生活的影响（PEG疼痛量表（PEG Pain Tool））以及受访者所使用的镇痛资源。本次项目新增的定量与半结构化问题，可为特定患者队列的需求分析提供有价值的洞见。

### 研究人群与样本
本次调查共回收问卷133份。剔除4份不合格问卷后（3份为重复问卷，1份受访者报告为急性疼痛而非慢性疼痛），最终有效样本量为129份。
卡方检验（Chi-square）结果显示，PEG评分与受访者是否仅就诊单一医疗服务提供者、就诊多家机构或未寻求疼痛诊疗之间无统计学关联（卡方值=5.040，P=0.282）。

最常用的镇痛药物为布洛芬，共有72名（59.59%）受访者报告使用；萘普生（22名，18.8%）和美洛昔康（8名，6.61%）亦为常见用药选择。超过六成（n=82，63.6%）的受访者使用非甾体类抗炎药（Non-Steroidal Anti-Inflammatory Drugs，NSAIDs），不足四分之一的受访者使用阿片类药物（n=30，23.3%）；另有17名（13.2%）受访者联合使用非甾体类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、使用非阿片类其他药物三类时，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）。
如受访者自述内容所示，PEG评分与自我效能感之间存在显著统计学关联。PEG评分重度的受访者更易在自述中体现出消极的自我效能感（Fisher-Freeman-Halton检验值=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，则更倾向于体现积极的自我效能感。
采用活动作为疼痛管理策略、采用其他管理策略或未采取任何疼痛管理措施三者之间，同样存在显著统计学关联（卡方值=18.967，P=0.001）。
PEG评分重度的受访者更易在自述中体现出消极的自我效能感（Fisher-Freeman-Halton检验值=17.952，P=0.001）。
采用活动作为疼痛管理策略、采用其他管理策略或未采取任何疼痛管理措施三者之间，存在显著统计学关联（卡方值=18.967，P=0.001）。