Strassels Scott A, Blough David K, Hazlet Thomas K, Veenstra David L, Sullivan Sean D
Division of Pharmacy Practice, University of Texas at Austin College of Pharmacy, Austin, Texas 78712, USA.
J Pain Symptom Manage. 2006 Dec;32(6):519-31. doi: 10.1016/j.jpainsymman.2006.06.005.
Pain in persons who receive hospice care is not fully understood. The purpose of this study was to describe the demographics, clinical characteristics, and pain intensity of persons who received hospice care in the United States from 2000-2004. Data for this study were obtained from a provider of hospice pharmacy services and included information about the hospice organization, demographics and clinical characteristics, pain intensity, and opioid analgesic prescribing. Worst pain intensity during the previous 24 hours was assessed using a 0-10 numeric rating scale (0=none, 10=worst) periodically during hospice care. During the study period, 347,555 persons received hospice services; 55.2% of these persons were female, 87.4% were Caucasian, and mean age was 75.3 years. At least one pain score was available for 156,887 (45.1%) individuals. Among persons with at least one pain score, pain was reported a mean of 2.9 times per person. Overall, mean pain intensity was mild, but severe pain was reported at least once by 20.3% of persons. Of individuals who reported severe pain at least once, mean age was 68.9 years, 53.7% were female, 78.0% were Caucasian, 7.4% were cared for in long-term care hospices, and 73.9% had a primary diagnosis of cancer. Severe pain was reported at least once by a substantial percentage of persons in this study. These data provide insight into pain reported by persons who received hospice care, and may be useful as process indicators of the quality of care.
临终关怀患者的疼痛情况尚未得到充分理解。本研究的目的是描述2000年至2004年在美国接受临终关怀的患者的人口统计学特征、临床特征和疼痛强度。本研究的数据来自一家临终关怀药房服务提供商，包括临终关怀机构的信息、人口统计学和临床特征、疼痛强度以及阿片类镇痛药的处方情况。在临终关怀期间，定期使用0至10的数字评分量表（0表示无疼痛，10表示最剧烈疼痛）评估前24小时内的最剧烈疼痛强度。在研究期间，347,555人接受了临终关怀服务；其中55.2%为女性，87.4%为白种人，平均年龄为75.3岁。156,887名（45.1%）个体至少有一个疼痛评分。在至少有一个疼痛评分的患者中，每人平均报告疼痛2.9次。总体而言，平均疼痛强度较轻，但20.3%的患者至少报告过一次重度疼痛。在至少报告过一次重度疼痛的个体中，平均年龄为68.9岁，53.7%为女性，78.0%为白种人，7.4%在长期护理临终关怀机构接受护理，73.9%的主要诊断为癌症。本研究中有相当比例的患者至少报告过一次重度疼痛。这些数据为接受临终关怀的患者报告的疼痛情况提供了见解，可能作为护理质量的过程指标。
