Wilson Keith G, Chochinov Hervey Max, Allard Pierre, Chary Srini, Gagnon Pierre R, Macmillan Karen, De Luca Marina, O'Shea Fiona, Kuhl David, Fainsinger Robin L
Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Ottawa, Canada.
Pain Res Manag. 2009 Sep-Oct;14(5):365-70. doi: 10.1155/2009/251239.
Pain is a common problem for people with cancer who are nearing the ends of their lives.
In the present multicentre Canadian study of palliative cancer care, the prevalence of pain, its perceived severity and its correlates across a range of physical, social, psychological, and existential symptoms and concerns were examined.
Semistructured interviews were conducted with 381 patients. In addition to inquiring about pain, the interview also assessed 21 other symptoms and concerns, and collected information about demographic characteristics, functional status and medication use.
Pain of any intensity was reported by 268 (70.3%) participants, although for 139 (36.5%), the severity was rated as minimal or mild. For 129 (33.9%) individuals, pain was reported as moderate to extreme, and considered by the respondents to be an important ongoing problem. Patients who reported moderate to extreme pain were younger than other participants, but had lower functional status and a shorter median survival duration. They were more likely than other participants to be treated with opioid medications (P<0.001) and, less reliably, with benzodiazepines (P=0.079). Compared with participants with no, minimal or mild pain, those with moderate to extreme pain had a higher prevalence of distressing problems on 11 of 21 other symptoms and concerns. The strongest correlations were with general malaise (rho = 0.44), suffering (rho = 0.40), nausea (rho = 0.34), weakness (rho = 0.31), drowsiness (rho = 0.29) and anxiety (rho = 0.29).
Pain continues to be a difficult problem for many patients who are receiving palliative cancer care, particularly younger individuals who are nearing death.
疼痛是晚期癌症患者的常见问题。
在加拿大这项关于姑息性癌症护理的多中心研究中，对疼痛的患病率、其感知严重程度以及一系列身体、社会、心理和生存症状及问题之间的相关性进行了研究。
对381名患者进行了半结构化访谈。除询问疼痛外，访谈还评估了其他21种症状和问题，并收集了有关人口统计学特征、功能状态和药物使用的信息。
268名（70.3%）参与者报告有任何强度的疼痛，不过其中139名（36.5%）的疼痛严重程度被评为轻微或轻度。129名（33.9%）个体报告疼痛为中度至重度，并被受访者视为一个持续存在的重要问题。报告中度至重度疼痛的患者比其他参与者更年轻，但功能状态较低，中位生存期较短。他们比其他参与者更有可能接受阿片类药物治疗（P<0.001），而接受苯二氮䓬类药物治疗的可能性则较低（P=0.079）。与无疼痛、轻微疼痛或轻度疼痛的参与者相比，中度至重度疼痛的参与者在其他21种症状和问题中有11种存在困扰问题的患病率更高。最强的相关性是与全身不适（相关系数=0.44）、痛苦（相关系数=0.40）、恶心（相关系数=0.34）、虚弱（相关系数=0.31）、嗜睡（相关系数=0.29）和焦虑（相关系数=0.29）。
对于许多接受姑息性癌症护理的患者，尤其是接近死亡的年轻患者来说，疼痛仍然是一个难题。
