Evangelista Lorraine S, Sackett Erin, Dracup Kathleen
School of Nursing, University of California, Los Angeles, California 90095-6918, USA.
Eur J Cardiovasc Nurs. 2009 Sep;8(3):169-73. doi: 10.1016/j.ejcnurse.2008.11.003. Epub 2009 Jan 15.
Although evidence exists to support the presence of pain in advanced stages of heart failure (HF), the pain experience in the early phases of this progressive disease is poorly documented, and therefore, poorly understood. The current study was conducted to: 1) examine the prevalence of pain in cohort of patients with chronic HF (New York Heart Association class I-IV); and 2) determine the relationship between pain and QOL.
Data were obtained from 300 patients (mean age 54.2+/-12.7 years; 72% male; 65% Caucasians; time since HF diagnosis 4.6+/-4.8 years). Two-thirds of the patients (67%) reported some degree of pain; the prevalence of pain increased as functional class worsened (p<.009). Differences in QOL outcomes for patients experiencing pain vs. no pain were statistically significant for physical and overall QOL. Pain accounted for 20% of the variance in QOL (p<.001) even after adjusting for age, gender, and functional class.
Our findings suggest pain is present in a majority of patients with HF. Given the potential deleterious effects of untreated pain on QOL in patients with HF, it is important that healthcare providers assess patients for this often-unrecognized symptom.
尽管有证据支持心力衰竭（HF）晚期存在疼痛，但这种进行性疾病早期的疼痛体验记录甚少，因此了解也不多。本研究旨在：1）调查慢性HF患者队列（纽约心脏协会I-IV级）中疼痛的患病率；2）确定疼痛与生活质量（QOL）之间的关系。
数据来自300例患者（平均年龄54.2±12.7岁；72%为男性；65%为白种人；自HF诊断以来的时间为4.6±4.8年）。三分之二的患者（67%）报告有一定程度的疼痛；疼痛的患病率随着功能分级的恶化而增加（p<0.009）。有疼痛与无疼痛患者的QOL结果在身体和总体QOL方面的差异具有统计学意义。即使在调整年龄、性别和功能分级后，疼痛仍占QOL方差的20%（p<0.001）。
我们的研究结果表明，大多数HF患者存在疼痛。鉴于未治疗的疼痛对HF患者QOL可能产生有害影响，医疗保健提供者评估患者是否存在这种常未被识别的症状很重要。
