Edrington Janet, Sun Angela, Wong Candice, Dodd Marylin, Padilla Geraldine, Paul Steven, Miaskowski Christine
School of Nursing, University of California at San Francisco, California, USA.
J Pain Symptom Manage. 2009 Apr;37(4):665-75. doi: 10.1016/j.jpainsymman.2008.04.014. Epub 2008 Nov 12.
Barriers to cancer pain management can contribute to the undertreatment of cancer pain. No studies have documented barriers to cancer pain management in Chinese American patients. The purposes of this study in a community sample of Chinese Americans were to: describe their perceived barriers to cancer pain management; examine the relationships between these barriers and patients' ratings of pain intensity, pain interference with function, mood disturbances, education, and acculturation level; and determine which factors predicted barriers to cancer pain management. Fifty Chinese Americans with cancer pain completed the following instruments: Brief Pain Inventory (BPI), Karnofsky Performance Status (KPS) Scale, Barriers Questionnaire (BQ), Hospital Anxiety and Depression Scale (HADS), Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), and a demographic questionnaire. The mean total BQ score was in the moderate range. The individual barriers with the highest scores were: tolerance to pain medicine; time intervals used for dosage of pain medicine; disease progression; and addiction. Significant correlations were found between the tolerance subscale and least pain (r=0.380) and the religious fatalism subscale and average pain (r=0.282). These two subscales were positively correlated with anxiety and depression levels: (tolerance: r=0.282, r=0.284, respectively; religious fatalism: r=0.358, r=0.353, respectively). The tolerance subscale was positively correlated with pain interference (r=0.374). Approximately 21% of the variance in the total BQ score was explained by patients' education level, acculturation score, level of depression, and adequacy of pain treatment. Chinese American cancer patients need to be assessed for pain and perceived barriers to cancer pain management to optimize pain management.
癌症疼痛管理的障碍可能导致癌症疼痛治疗不足。尚无研究记录华裔美国患者癌症疼痛管理的障碍。本研究以华裔美国人社区样本为对象，目的是：描述他们感知到的癌症疼痛管理障碍；研究这些障碍与患者疼痛强度评分、疼痛对功能的干扰、情绪障碍、教育程度和文化适应水平之间的关系；确定哪些因素可预测癌症疼痛管理的障碍。50名患有癌症疼痛的华裔美国人完成了以下量表：简明疼痛问卷（BPI）、卡氏功能状态量表（KPS）、障碍问卷（BQ）、医院焦虑抑郁量表（HADS）、苏因-刘亚洲自我认同文化适应量表（SL-ASIA）以及一份人口统计学问卷。BQ量表的总平均分处于中等范围。得分最高的个体障碍为：对止痛药的耐受性；止痛药给药的时间间隔；疾病进展；以及成瘾。耐受性分量表与最轻疼痛之间存在显著相关性（r = 0.380），宗教宿命论分量表与平均疼痛之间存在显著相关性（r = 0.282）。这两个分量表与焦虑和抑郁水平呈正相关：（耐受性：分别为r = 0.282，r = 0.284；宗教宿命论：分别为r = 0.358，r = 0.353）。耐受性分量表与疼痛干扰呈正相关（r = 0.374）。患者的教育水平、文化适应得分、抑郁水平和疼痛治疗的充分性解释了BQ量表总分约21%的变异。需要对华裔美国癌症患者的疼痛及感知到的癌症疼痛管理障碍进行评估，以优化疼痛管理。
