Faculty of Nursing, Oslo University College, Oslo, Norway.
J Pain Symptom Manage. 2009 Nov;38(5):717-26. doi: 10.1016/j.jpainsymman.2009.03.005. Epub 2009 Sep 22.
The purposes of this study were to determine a clinically significant cutpoint for worst pain and to evaluate for differences in the use of pain coping strategies between oncology inpatients with mild (i.e., worst pain intensity scores of <or=4) compared with moderate to severe (i.e., worst pain intensity scores of >4) pain based on results of the cutpoint analysis. Oncology inpatients in pain (n=224) completed the Coping Strategies Questionnaire (CSQ), the Brief Pain Inventory, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Fifty-six percent had moderate to severe pain. Patients in the moderate to severe pain group had significantly poorer Karnofsky Performance Status scores (P=0.04) and significantly lower ratings of overall health (P<0.0001). No differences were found between the two pain groups on any of the subscales of the CSQ, except catastrophizing (P<0.0001). Compared with the mild pain group, patients in the moderate to severe group scored significantly higher on this subscale. In addition, patients in the moderate to severe group used more passive coping strategies (P=0.02). Except for catastrophizing, the number and types of pain coping strategies used by this sample of hospitalized patients do not appear to be influenced by their pain intensity scores. Finally, when the CSQ scores of these hospitalized oncology patients were compared with those found in previous studies of oncology outpatients and patients with chronic noncancer pain, the scores were similar.
本研究旨在确定最痛的临床显著截断值,并评估在基于截断值分析结果的轻度(即,最痛强度评分≤4)与中重度(即,最痛强度评分>4)疼痛的肿瘤住院患者之间,疼痛应对策略的使用是否存在差异。(n=224)完成了应对策略问卷(CSQ)、简明疼痛量表和欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)。56%的患者有中重度疼痛。中重度疼痛组患者的 Karnofsky 表现状态评分(P=0.04)和总体健康评分(P<0.0001)明显较差。在 CSQ 的任何子量表上,两组患者之间均无差异,除了灾难化(P<0.0001)。与轻度疼痛组相比,中重度疼痛组患者在这一子量表上的得分明显更高。此外,中重度疼痛组患者使用更多的被动应对策略(P=0.02)。除了灾难化之外,该住院患者样本使用的疼痛应对策略的数量和类型似乎不受其疼痛强度评分的影响。最后,将这些住院肿瘤科患者的 CSQ 评分与之前的肿瘤科门诊患者和慢性非癌性疼痛患者的研究结果进行比较,发现评分相似。