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慢性非恶性疼痛患者报告的健康相关生活质量与晚期癌症患者一样差。

Chronic non-malignant pain patients report as poor health-related quality of life as palliative cancer patients.

作者信息

Fredheim O M S, Kaasa S, Fayers P, Saltnes T, Jordhøy M, Borchgrevink P C

机构信息

Pain and palliation research group, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Acta Anaesthesiol Scand. 2008 Jan;52(1):143-8. doi: 10.1111/j.1399-6576.2007.01524.x. Epub 2007 Nov 13.

Abstract

BACKGROUND

Patients with chronic non-malignant pain (CNMP) conditions are known to report reduced health-related quality of life (HRQoL). The objective of this exploratory study was to compare HRQoL between patients admitted to a multidisciplinary pain centre, palliative cancer (PC) patients and national norms.

METHODS

HRQoL data from 288 patients with CNMP admitted to the multidisciplinary pain centre at Trondheim University Hospital were compared with 434 patients with advanced cancer included in a trial of comprehensive palliative care in the hospital palliative medicine unit and national norms. HRQoL was assessed using the EORTC QLQ-C30. Age- and gender-adjusted norm data were calculated and compared between the two groups.

RESULTS

Scores from both groups deviated from adjusted norm data on all scales, with poorer functioning and more symptoms. Compared with PC patients, CNMP patients reported a larger deviation (worse scores) on global quality of life, cognitive functioning, pain, sleep disturbances and financial difficulties. Deviations from norm data were similar for physical, social and emotional functioning, diarrhoea, dyspnoea and fatigue. PC patients reported worse scores on role functioning, nausea/vomiting, loss of appetite and constipation.

CONCLUSION

CNMP patients admitted to multidisciplinary pain centres report significantly reduced HRQoL, in addition to severe pain. They consider their HRQoL to be as poor as HRQoL reported from dying cancer patients and substantially poorer than national norms. Factors other than the biological severity of the disease seem to be of major importance for self-reported HRQoL.

摘要

背景

已知患有慢性非恶性疼痛(CNMP)疾病的患者报告其健康相关生活质量(HRQoL)有所下降。这项探索性研究的目的是比较多学科疼痛中心收治的患者、姑息性癌症(PC)患者与国家规范之间的HRQoL。

方法

将特隆赫姆大学医院多学科疼痛中心收治的288例CNMP患者的HRQoL数据与该医院姑息医学科一项综合姑息治疗试验中纳入的434例晚期癌症患者的数据以及国家规范进行比较。使用欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ-C30)评估HRQoL。计算并比较两组的年龄和性别调整后的规范数据。

结果

两组在所有量表上的得分均偏离调整后的规范数据,功能较差且症状较多。与PC患者相比,CNMP患者在总体生活质量、认知功能、疼痛、睡眠障碍和经济困难方面的偏差更大(得分更差)。在身体、社会和情感功能、腹泻、呼吸困难和疲劳方面,与规范数据的偏差相似。PC患者在角色功能、恶心/呕吐、食欲不振和便秘方面的得分更差。

结论

入住多学科疼痛中心的CNMP患者除了疼痛严重外,报告的HRQoL也显著降低。他们认为自己的HRQoL与临终癌症患者报告的一样差,且远低于国家规范。除疾病的生物学严重程度外,其他因素似乎对自我报告的HRQoL至关重要。

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