Wiese C H R, Löffler E K, Vormelker J, Meyer N, Taghavi M, Strumpf M, Kazmaier S, Roessler M, Zausig Y A, Popov A F, Lassen C L, Graf B M, Hanekop G G
Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg.
Schmerz. 2010 Sep;24(5):508-16. doi: 10.1007/s00482-010-0956-5.
Cancer diseases are often associated with acute and chronic pain. Therefore, cancer pain is a symptom frequently reported by palliative care patients with cancer diseases. Prehospital emergency physicians may be confronted with exacerbation of pain in cancer patients. The aim of this study was to evaluate the knowledge of prehospital emergency physicians in training concerning cancer pain therapy.
A total of 471 prehospital emergency physicians received a questionnaire (period of time: 2007-2009). The questionnaire was prepared for the study ("mixed methods design"). Twenty-four questions concerning cancer pain therapy (response options: scaling, open) were designed. The evaluation was done descriptively according to professional experience, field name and experience in treating patients with cancer as well.
A total of 469 participants completed the questionnaire (response rate 99%). On average, 10.8 (SD +5.7, range 2-24) questions were answered correctly. Resident physicians answered statistically significantly more questions correctly than consultants (p=0.02). Only physicians working in internal medicine achieved statistically significantly better results than other disciplines (e.g., surgery; p=0.01). Physicians with professional experience of less than 5 years answered statistically significantly more questions correctly (p=0.004).
The results of this study verify that emergency physicians in training have insufficient knowledge of pain therapy and end-of-life decisions. The data of this investigation suggest that more attention should be paid to education on pain therapy and end-of-life care in medical curricula. Prehospital emergency physicians may thus be better prepared to provide quality care for palliative patients.
癌症疾病常伴有急慢性疼痛。因此，癌痛是癌症姑息治疗患者经常报告的一种症状。院前急救医生可能会遇到癌症患者疼痛加剧的情况。本研究的目的是评估接受培训的院前急救医生关于癌症疼痛治疗的知识水平。
共有471名院前急救医生收到了一份调查问卷（时间跨度：2007年至2009年）。该问卷是为该研究准备的（“混合方法设计”）。设计了24个关于癌症疼痛治疗的问题（回答选项：量表式、开放式）。根据专业经验、专业领域以及治疗癌症患者的经验进行描述性评估。
共有469名参与者完成了问卷（回复率99%）。平均正确回答了10.8个问题（标准差±5.7，范围2至24）。住院医生回答正确的问题在统计学上显著多于会诊医生（p = 0.02）。只有内科医生取得的结果在统计学上显著优于其他学科（如外科；p = 0.01）。专业经验少于5年的医生回答正确的问题在统计学上显著更多（p = 0.004）。
本研究结果证实，接受培训的急救医生在疼痛治疗和临终决策方面知识不足。本次调查的数据表明，医学课程应更加重视疼痛治疗和临终关怀教育。这样，院前急救医生可能会更好地为姑息治疗患者提供优质护理。
