Department of Public Health, University of Patras, Greece.
Eur J Oncol Nurs. 2011 Dec;15(5):442-6. doi: 10.1016/j.ejon.2010.10.008. Epub 2010 Nov 18.
Pain is not only one of the most undesirable side effects of cancer but also one of its major complications. This study attempted to evaluate and describe the pain characteristics and pain control in patients with advanced cancer and to identify factors related to effective analgesic treatment.
A descriptive cross-sectional study involving the eight larger oncology centres in Greece was conducted in 2008. Cancer patients (n = 134) attending the oncology outpatient departments were interviewed using a 35-item questionnaire regarding pain- and treatment-related characteristics.
The great majority of the patients (72%) with advanced malignancy reported high pain intensity and 66.4% experienced the pain as continuous. Although most patients (81%) responded to treatment, more than 30% reported side effects and asked for treatment to change. Better informed patients about the disease showed higher response to pain treatment (OR 3.21; 95%CI 1.28-8.01). Adherence to treatment was related to pain response (OR 3.05; 95%CI 1.06-8.75), whereas negative attitudes and feelings toward treatment were related with reluctance to take analgesic treatment (OR 4.27; 95%CI 1.31-13.89). Patients' request for changing medication was significantly related to the presence of side effects (OR 8.26; 95%CI 2.80-24.42) and pain response to treatment (OR 0.09; 95%CI 0.03-0.31).
Negative attitudes and feelings toward treatment combined with deficits in patient education/information seem to influence both pain response and therapy compliance suggesting the need for more comprehensive approach to pain management of cancer patients.
疼痛不仅是癌症最令人不适的副作用之一,也是其主要并发症之一。本研究试图评估和描述晚期癌症患者的疼痛特征和疼痛控制情况,并确定与有效镇痛治疗相关的因素。
2008 年在希腊的 8 个大型肿瘤中心进行了一项描述性的横断面研究。癌症患者(n=134)在肿瘤门诊接受了一项 35 项的问卷调查,内容涉及疼痛和治疗相关特征。
绝大多数(72%)患有晚期恶性肿瘤的患者报告疼痛强度高,66.4%的患者报告疼痛持续存在。尽管大多数(81%)患者对治疗有反应,但超过 30%的患者报告有副作用,并要求改变治疗方案。对疾病了解更多的患者对疼痛治疗的反应更高(OR 3.21;95%CI 1.28-8.01)。治疗依从性与疼痛反应有关(OR 3.05;95%CI 1.06-8.75),而对治疗的消极态度和感受与不愿意接受镇痛治疗有关(OR 4.27;95%CI 1.31-13.89)。患者要求更换药物与副作用的存在(OR 8.26;95%CI 2.80-24.42)和对治疗的疼痛反应(OR 0.09;95%CI 0.03-0.31)显著相关。
对治疗的消极态度和感受加上患者教育/信息的不足似乎会影响疼痛反应和治疗依从性,这表明需要对癌症患者的疼痛管理采取更全面的方法。