Schmerz最新文献

To evaluate the quality of care, particularly in the case of new forms of healthcare interventions, the healthcare services to be provided are defined and documented in advance. The presented explanatory sequential mixed methods design combines quantitative and qualitative data collection and the analysis enables a deeper understanding of a new healthcare intervention. Using the example of the POET-Pain project, which investigates the effect of a perioperative transitional pain service (TPS), the methodological application of the explanatory sequential mixed methods design is demonstrated in order to present the structural and process evaluation of the new healthcare intervention (in this case TPS) and to understand its influence on the quality of care. The mixed methods design presented enables the results of the quantitative phase to be interpreted and expanded in depth using qualitative data, which leads to a comprehensive understanding of the subject matter (second pillar of health services research).

Health services research looks at a form of care under contextual conditions. Often, and especially in the treatment of recurrent or chronic pain, these forms of care are complex interventions. Ensuring internal validity for subsequent interpretability of the results achieved as an essential requirement for studies in health services research therefore presents researchers with the challenge that they have to develop complex study protocols and implement and monitor them in clinical care. By its very nature, interdisciplinary multimodal pain therapy (IMST) involves multimodal interventions in an interdisciplinary care setting. In the reality of care, contextual factors for the effectiveness and feasibility of IMST are of great importance. On the one hand, health services research provides appropriate recommendations for the planning, implementation and evaluation of studies on complex interventions under contextual conditions, which can be of great importance for further research into the effectiveness of IMST. On the other hand, experience from interdisciplinary pain research can also help to successfully plan and conduct studies on complex interventions. This article introduces the understanding of interdisciplinarity (and interprofessionalism) in pain medicine and research, outlines possible key points for study planning and implementation using the example of two health services research studies and concludes by discussing gaps in research on interdisciplinary collaboration in pain medicine and research.

In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). Detailed recommendations exist for the planning and implementation of effectiveness studies on complex interventions, to which interdisciplinary multimodal pain therapy undoubtedly belongs. In an effectiveness model, concrete, verifiable assumptions are formulated as to how an intervention produces changes that are reflected in the endpoint. This article provides a brief introduction to methodological approaches to effectiveness research on complex interventions and uses the PAIN 2.0 project (01NVF20023) to describe in concrete terms what an effectiveness model for interdisciplinary multimodal pain therapy for the prevention of chronic pain in an outpatient setting might look like.

In health services research, the health care of the population is examined under everyday conditions. Scientific questions include medical, patient-oriented, system-, performance- and quality-related as well as health economics topics. In health services research, complex interventions, e.g., treatment concepts with multiple therapy components, and/or across multiple sectors, are often implemented. The design of studies in health services research is based on the research question, the setting, and the available data, which can come from a variety of sources.

Background: Up to the early 2000s the need for optimization in the treatment of acute pain in hospitals was highlighted. Only a few successes were achieved in the optimization process. As the acute pain care in Germany remained persistently unsatisfactory, the first health services research projects in pain medicine were initiated. These were intended to achieve improvements in patient care.

Aim: To illustrate the beginnings of health services research in the field of pain medicine in Germany the research projects "Pain-free hospital" and "Action alliance pain-free City of Münster" as well as the certification initiative Certkom are described.

Material and methods: An analysis of the current state of pain care for patients and interdisciplinary pain management, the derivation of optimization measures, their implementation and subsequent evaluation were carried out in all the projects presented in the sense of a complex intervention.

Results: All the projects could achieve improvements in patient care through a systematic survey of the current situation, targeted planning and the introduction of optimization measures. Corresponding evaluations could demonstrate these results.

Conclusion: The systematic approach in the projects with the collation of scientific data in real-life care has achieved optimization in acute pain management. The foundations were laid for further healthcare research in pain treatment in Germany; however, the projects also revealed limitations in the inclusion of vulnerable patient groups.