Miaskowski Christine
Department of Physiological Nursing, University of California, San Francisco, USA.
Oncol Nurs Forum. 2010 Sep;37 Suppl:27-32. doi: 10.1188/10.ONF.S1.27-32.
PURPOSE/OBJECTIVES: To identify the most appropriate outcome measures to determine the effectiveness of pain management plans in older adults with cancer.
PubMed literature searches, medical and nursing textbooks, and clinical experience.
Unrelieved chronic pain can have a significant impact on older adults' activity levels and their ability to function. Hence, effective pain management in older adults requires a comprehensive approach, including assessment of functional outcomes. Because the goals of pain management are broad, healthcare professionals should use an array of functional outcome measures along with pain intensity ratings to better assess the effectiveness of analgesic medications.
Particularly in older adults, evaluation of functional outcomes provides a better indication of the effectiveness of pain management strategies than pain intensity ratings. Appropriate outcome measures for older adults in the outpatient setting include pain relief, physical functioning, emotional functioning, patients' ratings of global improvement and satisfaction with treatment, and symptoms and adverse effects associated with analgesic medications.
Healthcare providers should manage pain in older adults with cancer in an interdisciplinary environment with pharmacologic and nonpharmacologic interventions. The primary goals are decreasing pain and improving function and quality of life.
目的/目标：确定最合适的结局指标，以判定针对老年癌症患者的疼痛管理计划的有效性。
PubMed文献检索、医学与护理教科书以及临床经验。
未缓解的慢性疼痛会对老年人的活动水平及其功能能力产生重大影响。因此，对老年人进行有效的疼痛管理需要采取综合方法，包括对功能结局的评估。由于疼痛管理的目标广泛，医疗保健专业人员应使用一系列功能结局指标以及疼痛强度评级，以更好地评估止痛药物的有效性。
特别是在老年人中，与疼痛强度评级相比，对功能结局的评估能更好地表明疼痛管理策略的有效性。门诊环境中适用于老年人的结局指标包括疼痛缓解情况、身体功能、情绪功能、患者对整体改善情况及治疗满意度的评级，以及与止痛药物相关的症状和不良反应。
医疗保健提供者应在跨学科环境中，通过药物和非药物干预措施来管理老年癌症患者的疼痛。主要目标是减轻疼痛、改善功能和提高生活质量。
