METHODS: Systematic review without meta-analysis.
METHODS: Key words \"chronic pain,\" \"veterans,\" and \"injuries\" were used to search for articles in the MEDLINE, CINAHL, APA PsycInfo, and Embase databases. Articles published in English between 2000 and 2023 were included.
METHODS: A systematic literature search was conducted in June 2020, updated in April 2023, and managed using Covidence review software. Inclusion criteria focused on combat-injured veterans with chronic pain, excluding nonveterans and civilians treated for acute or chronic pain. Data from included studies were extracted, summarized, and critically appraised using the 2018 Mixed Methods Appraisal Tool. This review is registered with PROSPERO (CRD42020207435).
RESULTS: Fourteen studies met the inclusion criteria, with 10 of them supporting nonpharmacological approaches for managing chronic pain among veterans of armed conflicts and wars. Interventions included psychological/behavioral therapies, peer support, biofeedback training via telephone-based therapy, manual therapy, yoga, cognitive processing therapy, cognitive-behavioral therapy, and social and community integration to reduce pain intensity and enhance functional outcomes.
CONCLUSIONS: Nonpharmacological treatments for chronic pain have increased in recent years, a shift from earlier reliance on pharmacological treatments. More evidence from randomized controlled trials on the benefits of combined pain interventions could improve pain management of veterans with complex care needs.
方法:无荟萃分析的系统评价。
方法:关键词“慢性疼痛,\"\"退伍军人,\"和\"伤害\"用于搜索MEDLINE中的文章,CINAHL,APAPsycInfo,和Embase数据库。包括2000年至2023年之间以英文发表的文章。
方法:于2020年6月进行了系统的文献检索,于2023年4月进行了更新,并使用Covidence审查软件进行了管理。纳入标准侧重于患有慢性疼痛的战斗受伤退伍军人,不包括接受急性或慢性疼痛治疗的非退伍军人和平民。提取纳入研究的数据,总结,并使用2018年混合方法评估工具进行批判性评估。本评论在PROSPERO(CRD42020207435)注册。
结果:14项研究符合纳入标准,其中10人支持非药物方法来管理武装冲突和战争退伍军人的慢性疼痛。干预措施包括心理/行为疗法,同行支持,通过电话疗法进行生物反馈训练,手动治疗,瑜伽,认知加工疗法,认知行为疗法,以及社会和社区融合,以减少疼痛强度并增强功能结果。
结论:近年来慢性疼痛的非药物治疗有所增加,从早期依赖药物治疗的转变。来自随机对照试验的更多证据表明联合疼痛干预措施的益处可以改善具有复杂护理需求的退伍军人的疼痛管理。