PDF(Pubmed)
Abstract：
Objective: This study aimed to explore perspectives of people living with sickle cell disease (SCD) and SCD clinic providers and staff about the use of acupuncture and guided relaxation for treating chronic SCD pain. Data obtained were to inform an implementation blueprint for an effectiveness implementation clinical trial (GRACE Trial) testing whether acupuncture or guided relaxation reduces chronic pain when compared with usual care. Design: Qualitative research design. Methods: We conducted 33 semistructured interviews with people with SCD and SCD clinic providers and staff. Interviews were transcribed and coded. A deductive content analysis process was used to identify themes. Results: Four themes were identified: Receptivity to Acupuncture and Guided Relaxation, Limited Awareness, Complementary and Integrative Health (CIH) Therapy Preference, and Access Barriers. Both patients and clinic providers and staff were open to the use of acupuncture and guided relaxation for chronic pain treatment. After learning about these CIH therapies, some patients expressed a preference for one therapy over the other. They also discussed their ability to successfully engage with each therapy. There is a need to dispel misconceptions about the therapies by increasing understanding of how each therapy is implemented and functions to reduce pain. We identified several potential barriers that might affect the success of the trial and future health system integration, including time, transportation, and technology. Conclusion: This study is one of the first to present perspectives of both patients with SCD and clinic providers and staff on the use of acupuncture and guided relaxation for chronic SCD pain. Stakeholders\' early input and perspectives highlighted that they welcome nonpharmacological CIH therapies. Implementation of a clinical trial and future health system integration will require the addressing misinformation and identifying strategies to overcome access barriers. Clinical trial registration number: NCT04906447.
摘要：
目的：本研究旨在探讨镰状细胞病（SCD）患者和SCD诊所提供者和工作人员对使用针灸和引导放松治疗慢性SCD疼痛的观点。获得的数据是为有效性实施临床试验（GRACE试验）提供实施蓝图，测试与常规护理相比，针灸或引导放松是否可以减少慢性疼痛。设计：定性研究设计。方法：我们对SCD和SCD诊所提供者和工作人员进行了33次半结构化访谈。采访被转录和编码。使用演绎内容分析过程来识别主题。结果：确定了四个主题：对针刺和引导放松的接受度，意识有限,补充和综合健康(CIH)治疗偏好，和进入壁垒。患者，诊所提供者和工作人员都愿意使用针灸和引导放松来治疗慢性疼痛。在了解了这些H疗法之后，一些患者表达了对一种疗法的偏好。他们还讨论了他们成功参与每种疗法的能力。需要通过增加对每种疗法如何实施和减轻疼痛的功能的理解来消除对疗法的误解。我们发现了一些可能影响试验成功和未来卫生系统整合的潜在障碍，包括时间,交通运输,和技术。结论：这项研究是首次提出SCD患者以及临床提供者和工作人员对使用针灸和引导放松治疗慢性SCD疼痛的观点之一。利益相关者的早期投入和观点强调，他们欢迎非药理学CIH疗法。实施临床试验和未来的卫生系统整合将需要解决错误信息并确定克服获取障碍的策略。ClinicalTrials.gov标识符：NCT04906447。
