Schmerzbehandlungszentren in den USA: Organisation, Therapieprogramme, Effizienz

  • B. Kröner-Herwig

Zusammenfassung

Die Erkenntnis, daß chronischer Schmerz mit konventionellen, sich am Modell des akuten Schmerzes orientierenden Behandlungsformen, nicht erfolgreich therapierbar ist, fand in den USA schon relativ früh eine pragmatische Umsetzung. Ende der 60er Jahre wurden die ersten “pain centers” oder “pain clinics” gegründet, deren Behandlungskonzepte auf einem multidisziplinären Ansatz fußen. Eine der frühesten Gründungen war das Schmerzzentrum an der University of Washington School of Medicine in Seattle, mit dem sich v.a. die namen Bonica, Loeser und Fordyce verbinden. Fordyce entwickelte dort seinen operanten Ansatz der Schmerzbewältigung, an dem sich heute die meisten der interdisziplinären Behandlungszentren orientieren (Fordyce 1976). Von diesem Zentrum ging ein ungeheurer Motivationsschub für die Schmerzforschung und die Einrichtung von Schmerztherapiezentren aus. Heute soll es in den USA ca. 1200 Schmerzkliniken geben (Crue 1983, zit. nach Newman u. Seres 1986).

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© Springer-Verlag Berlin Heidelberg 1990

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  • B. Kröner-Herwig

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