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Distress tolerance among emergency department patients in acute pain: Associations with substance use treatment
Stress & Health ( IF 3.0 ) Pub Date : 2020-12-23 , DOI: 10.1002/smi.3020
Maria L Pacella-LaBarbara 1 , Caroline Maltese 1 , Madelyn McConaghy 1 , James Porter 1 , Michael L Young 1 , Brian Suffoletto 2
Affiliation  

Managing acute pain in individuals with a history of substance use disorders (SUD) is complex. Distress tolerance (DT) (e.g., the ability to handle uncomfortable sensations) may serve as an ideal non-pharmacological intervention target in this population. Among 293 emergency department (ED) patients seeking treatment for pain (Mage = 41; 42% Female; 43% Black), we examined rates of SUD treatment and DT, whether an objective DT task is feasible to conduct in the ED, and relationships between DT and SUD. Patients completed a self-report DT survey, an objective DT task, and brief surveys of pain, drug use, current or past SUD treatment, and depression/anxiety. Average DT was 18.50 (SD = 9.4) out of 50; patients with past or current SUD treatment (n = 43; 14.7%) reported lower DT than patients with no SUD treatment history (n = 250; 85.3%). Controlling for demographics, depression/anxiety, and pain severity, lower subjective DT (adjusted odds ratio [aOR] = 1.05) and objective DT (aOR = 1.02) was associated a current or past history or SUD treatment. Assessing subjective and objective DT in ED patients with acute pain is feasible; interventions aimed at boosting DT may improve outcomes among patients with acute pain and SUD.

中文翻译:

急诊科急性疼痛患者的痛苦耐受性:与物质使用治疗的关联

管理有物质使用障碍 (SUD) 病史的个体的急性疼痛是复杂的。痛苦耐受(DT)(例如,处理不舒服感觉的能力)可以作为该人群理想的非药物干预目标。在寻求疼痛治疗的 293 名急诊科 (ED) 患者中(M年龄 = 41;42% 女性;43% 黑人),我们检查了 SUD 治疗率和 DT,客观的 DT 任务在 ED 中是否可行,以及DT 和 SUD 之间的关系。患者完成了自我报告的 DT 调查、客观的 DT 任务以及对疼痛、药物使用、当前或过去的 SUD 治疗以及抑郁/焦虑的简要调查。平均 DT 为 18.50 ( SD  = 9.4),满分 50;过去或当前接受过 SUD 治疗的患者(n = 43; 14.7%) 报告的 DT 低于没有 SUD 治疗史的患者 ( n  = 250; 85.3%)。控制人口统计学、抑郁/焦虑和疼痛严重程度,降低主观 DT(调整优势比 [aOR] = 1.05)和客观 DT(aOR = 1.02)与当前或过去的病史或 SUD 治疗相关。评估急性疼痛 ED 患者的主观和客观 DT 是可行的;旨在提高 DT 的干预措施可能会改善急性疼痛和 SUD 患者的预后。
更新日期:2020-12-23
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