Miaskowski C, Lee K A
Department of Physiological Nursing, University of California, San Francisco 94143-0610, USA.
J Pain Symptom Manage. 1999 May;17(5):320-32. doi: 10.1016/s0885-3924(99)00008-1.
Pain and fatigue are two of the most common problems experienced by oncology patients. This study evaluated 24 oncology patients who were receiving radiation therapy for bone metastases to (1) describe the patterns of pain intensity and fatigue severity over a 48-hour period; (2) evaluate for sleep disturbances; (3) describe the relationships between these symptoms and various treatment characteristics; and (4) describe the self-care strategies used by patients to manage pain and fatigue. Patients reported moderate amounts of pain and fatigue. Average pain scores did not vary significantly over a 48-hour period. However, patients reported significantly lower fatigue scores in the morning compared to the evening. In addition, patients experienced significant sleep disturbances, with a mean sleep efficiency index of 70.7% (estimated using wrist actigraphy). Patients with lower Karnofsky Performance Status scores reported more sleep disturbances. In addition, patients who had received a higher percentage of their radiation treatment reported more sleep disturbances. Patients used a variety of self-care strategies to manage pain and fatigue. Additional research is warranted to describe more completely the patterns of pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy.
疼痛和疲劳是肿瘤患者最常遇到的两个问题。本研究评估了24名因骨转移接受放射治疗的肿瘤患者，以(1)描述48小时内疼痛强度和疲劳严重程度的模式；(2)评估睡眠障碍情况；(3)描述这些症状与各种治疗特征之间的关系；以及(4)描述患者用于管理疼痛和疲劳的自我护理策略。患者报告了中度的疼痛和疲劳。平均疼痛评分在48小时内没有显著变化。然而，与晚上相比，患者报告早上的疲劳评分显著更低。此外，患者经历了显著的睡眠障碍，平均睡眠效率指数为70.7%（使用手腕活动记录仪估算）。卡诺夫斯基功能状态评分较低的患者报告有更多的睡眠障碍。此外，接受放射治疗比例较高的患者报告有更多的睡眠障碍。患者使用了多种自我护理策略来管理疼痛和疲劳。有必要进行更多研究，以更全面地描述接受放射治疗的肿瘤门诊患者的疼痛、疲劳和睡眠障碍模式。
