School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
Clin J Pain. 2011 Feb;27(2):116-24. doi: 10.1097/AJP.0b013e3181f3f667.
pain is one of the most prevalent symptoms in patients with advanced cancer and, according to anecdotal reports, perhaps the most feared. Surprisingly, fear of pain has been the subject of little research within cancer care. The literature on chronic noncancer pain, however, suggests that fear of pain contributes to limitations in function in populations with diverse chronic illness. Little is known about the extent to which such findings might generalize from patients with chronic noncancer pain to those with chronic cancer pain. Therefore, this research examined the extent to which fear of pain is associated with limitations in function in patients with advanced cancer and also compared patients with chronic cancer and noncancer pain.
we recruited 117 patients with advanced cancer who received a referral for pain management and 118 patients with a primary complaint of chronic noncancer pain. Participants completed self-report questionnaires.
findings revealed similarities between the groups for fear of pain and limitations in function, but they differed on level of depression and pain severity (patients with noncancer pain were more depressed and reported higher pain severity). Fear of pain independently predicted limitations in function in both groups controlling for demographic variables and pain severity. When depression and physical symptoms were controlled, fear of pain predicted limitations in function only in patients with advanced cancer.
the findings emphasize the importance of psychological dimensions of pain in patients with advanced cancer, as well as the similarities and differences between the 2 groups of patients suffering from chronic pain.
疼痛是晚期癌症患者最常见的症状之一，据传闻，也是最令人恐惧的症状。令人惊讶的是，在癌症护理领域，对疼痛恐惧的研究甚少。然而，慢性非癌症疼痛的文献表明，疼痛恐惧会导致患有各种慢性疾病的人群的功能受限。对于慢性非癌症疼痛患者的这些发现有多大程度可以推广到患有慢性癌症疼痛的患者，目前知之甚少。因此，本研究旨在探讨疼痛恐惧在晚期癌症患者的功能受限中的程度，并比较患有慢性癌症和非癌症疼痛的患者。
我们招募了 117 名接受疼痛管理转介的晚期癌症患者和 118 名患有慢性非癌症疼痛主要抱怨的患者。参与者完成了自我报告问卷。
研究结果显示，两组患者在疼痛恐惧和功能受限方面存在相似之处，但在抑郁程度和疼痛严重程度上存在差异（非癌症疼痛患者的抑郁程度更高，报告的疼痛严重程度更高）。在控制人口统计学变量和疼痛严重程度后，疼痛恐惧独立预测了两组患者的功能受限。当控制抑郁和身体症状时，疼痛恐惧仅在晚期癌症患者中预测功能受限。
这些发现强调了晚期癌症患者疼痛的心理维度的重要性，以及患有慢性疼痛的两组患者的相似性和差异性。
