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在定期接受阿片类镇痛药治疗的癌痛住院患者中,情绪障碍与疼痛、希望和生活质量之间的关系。

The relationships between mood disturbances and pain, hope, and quality of life in hospitalized cancer patients with pain on regularly scheduled opioid analgesic.

机构信息

Faculty of Nursing, Oslo University College, Oslo, Norway.

出版信息

J Palliat Med. 2010 Mar;13(3):311-8. doi: 10.1089/jpm.2009.0294.

Abstract

OBJECTIVE

The study purposes were to describe the percentage of patients in one of four mood groups (i.e., neither anxiety nor depression [NEITHER], only anxiety [ANX], only depression [DEP], both anxiety and depression [BOTH]) and to evaluate how differences in mood states are related to pain, hope, and quality of life (QOL).

METHODS

Oncology inpatients (n = 225) completed Brief Pain Inventory, Herth Hope Index (HHI), and the European Organization for Research and Treatment of Cancer Core QOL Questionnaire-C30. Research nurses completed Symptom Severity Checklist, Karnofsky Performance Status score, and medical record reviews. Data were analyzed using chi(2), Kruskal-Wallis, one-way analyses of variance (ANOVAs), and analyses of covariance (ANCOVA).

RESULTS

Thirty-two percent of patients were categorized in the NEITHER group, 12% in the ANX group, 12% in the DEP group, and 44% in the BOTH group. Younger patients and women were more likely to be in the BOTH group. While only minimal differences were found among the mood groups on pain intensity scores, patients in the NEITHER group in general, reported lower pain interference scores than those in the other three groups. Significant differences were found in HHI scores between the patients in the NEITHER group and the BOTH group. In addition, patients with both mood disorders reported significantly poorer QOL scores.

CONCLUSIONS

Because 44% of the patients had both anxiety and depression, clinicians need to evaluate patients for the co-occurrence of these two symptoms, evaluate its impact on pain management, hope, and QOL, and develop appropriate interventions to manage these symptoms.

摘要

目的

本研究旨在描述处于以下四种情绪状态之一的患者比例(即无焦虑且无抑郁[既非焦虑也非抑郁(NEITHER)]、仅有焦虑[ANX]、仅有抑郁[DEP]、同时存在焦虑和抑郁[BOTH]),并评估情绪状态的差异与疼痛、希望和生活质量(QOL)之间的关系。

方法

肿瘤内科住院患者(n=225)完成简明疼痛量表、赫尔辛基希望量表(HHI)和欧洲癌症研究与治疗组织核心 QOL 问卷-C30。研究护士完成症状严重程度检查表、卡诺夫斯基表现状态评分和病历回顾。采用卡方检验、克鲁斯卡尔-沃利斯检验、单向方差分析(ANOVA)和协方差分析(ANCOVA)进行数据分析。

结果

32%的患者被归类为 NEITHER 组,12%为 ANX 组,12%为 DEP 组,44%为 BOTH 组。年轻患者和女性更有可能处于 BOTH 组。尽管在疼痛强度评分方面,不同情绪组之间仅存在微小差异,但一般来说,NEITHER 组患者的疼痛干扰评分低于其他三组。在 HHI 评分方面,NEITHER 组和 BOTH 组之间存在显著差异。此外,同时存在两种情绪障碍的患者报告的 QOL 评分明显更差。

结论

由于 44%的患者同时存在焦虑和抑郁,临床医生需要评估患者是否同时存在这两种症状,评估其对疼痛管理、希望和 QOL 的影响,并制定适当的干预措施来管理这些症状。

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