Answering the call to address chronic pain in military service members and veterans: Progress in improving pain care and restoring health

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• 作者：Bruce A. Schoneboom ; PhD ; CRNA ; FAAN ; COL (Ret)^a ; ^{bschoneboom@aana.com" class="auth_mail" title="E-mail the corresponding author} ; Susan M. Perry ; PhD ; CRNA ; ARNP ; COL ; USAF ; NC (Ret)^b ; William Keith Barnhill ; PhD ; CRNA ; ARNP^c ; Nicholas A. Giordano ; BSN ; RN^d ; Kelly L. Wiltse Nicely ; PhD ; MSN ; CRNA^e ; Rosemary C. Polomano ; PhD ; RN ; FAAN^f
• 关键词：Chronic pain ; Military ; Veterans ; Pain management ; Advanced practice registered nurses
• 刊名：Nursing Outlook
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：64
• 期：5
• 页码：459-484
• 全文大小：1081 K

文摘

Chronic noncancer pain (CNCP) in military and veteran populations mirrors the experience of chronic pain in America; however, these two populations have unique characteristics and comorbid conditions such as traumatic brain injuries, postconcussive syndrome, posttraumatic stress disorder, and behavioral health disorders that complicate the diagnosis and treatment of chronic pain. Military members and veterans may also be stigmatized about their conditions and experience problems with integration back into healthy lifestyles and society as a whole following deployments and after military service. The military and veteran health care systems have made chronic pain a priority and have made substantial strides in addressing this condition through advances in practice, education, research, and health policy. Despite this progress, significant challenges remain in responding to the wide-spread problem of chronic pain. The purpose of this article is to: (a) examine the state of CNCP in military and veteran populations; (b) discuss progress made in pain practice, education, research, and health policy; and (c) examine research, evidence-based practice guidelines, and expert consensus reports that are foundational to advancing pain care and improving health for military service members and veterans with CNCP. In addition, recommendations are proposed to address this widespread health problem through the expanded use of advanced practice registered nurses, the implementation of models of care, and use of national resources to educate health care providers, support practice, and promote effective pain care.