Department of Thoracic Surgery, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, People's Republic of China.
Support Care Cancer. 2010 Nov;18(11):1455-60. doi: 10.1007/s00520-009-0768-2. Epub 2009 Nov 10.
The WHO's three-step guideline for cancer pain management has been introduced in China; however, there remain large differences in the standards of cancer pain management between China and other developed countries. This survey was carried out to determine the degree of physician knowledge on morphine use and the factors that impede morphine use in clinical practice in China.
A self-reported questionnaire was designed and administered to randomly selected physicians in four tertiary hospitals in the cities of Changchun and Changsha in China. Statistical analyses were conducted using SPSS statistical software.
Two hundred and one clinical physicians participated in the survey. Physicians who reported having received training in cancer pain management and drug use demonstrated a significantly higher mean score of basic knowledge compared to physicians who reported not having received training (9.31 ± 2.88:8.23 ± 2.70, u = 2.74, p < 0.001). The top three cited impediments to widespread clinical use of morphine for cancer pain were: (1) lack of professional knowledge and training; (2) fear of opioid addiction; and (3) physicians' personal preferences to select other drugs.
Medical staffs lack the basic knowledge and harbor misconceptions about the clinical use of morphine for cancer pain treatment. Creating training opportunities for medical staffs is necessary to increase their awareness and knowledge of effective cancer pain management.
世界卫生组织（WHO）的癌症三阶梯止痛治疗原则已在中国推行，但中国在癌症疼痛管理标准方面与其他发达国家仍存在较大差距。本调查旨在了解中国临床医生对吗啡使用相关知识的掌握程度以及影响吗啡临床应用的因素。
设计并向中国长春市和长沙市的 4 家三级医院的随机选择的医生发放自填式问卷。使用 SPSS 统计软件进行统计分析。
201 名临床医生参与了调查。与未接受过癌症疼痛管理和药物使用培训的医生相比，接受过培训的医生的基础知识平均得分显著更高（9.31±2.88 比 8.23±2.70，u=2.74，p＜0.001）。广泛应用吗啡治疗癌症疼痛的三大主要障碍为：（1）缺乏专业知识和培训；（2）担心阿片类药物成瘾；（3）医生个人偏好选择其他药物。
医务人员对吗啡治疗癌症疼痛的临床应用缺乏基本的了解，存在误解。为医务人员创造培训机会是提高他们对有效癌症疼痛管理的认识和知识的必要条件。
