Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, 120 East 16th Street, 12th Floor, New York, New York 10003, USA.
Oncologist. 2011;16(4):523-33. doi: 10.1634/theoncologist.2010-0330. Epub 2011 Mar 14.
Little is known about cancer pain in Chinese Americans. The objective of this study was to describe the epidemiology of pain in this population. This information is needed to identify and address unmet clinical needs for culturally relevant interventions targeting pain and its consequences.
A consecutive sample of underserved ethnic Chinese patients in a large community-based oncology practice was screened for persistent or frequent pain. Those patients with pain completed translated instruments assessing demographics, linguistic acculturation, disease-related characteristics, and pain-related characteristics.
Of 312 patients screened, 178 (57.1%) reported frequent or persistent pain, 175 were eligible, and 170 participated. Most participants (85.9%) were born in China and 84.7% overall spoke Cantonese only. The most common cancers were gastrointestinal (28.2%), lung (21.8%), breast (20.6%), head and neck (12.9%), and genitourinary (4.7%); 43.5% had metastatic disease. The mean worst pain severity on a 0-10 numeric scale was 4.7 (standard deviation, 2.4), with 28.2% of patients rating their worst pain at ≥7 of 10. Although 37.6% used opioids and 47.1% used nonopioids, 45.8% reported "little" or "no" pain relief from medications. Complementary or alternative medicine therapies for cancer pain were used by 35.8%. In multiple regression analyses, worst pain was positively associated with acculturation to the English language and opioid therapy, and pain-related distress was positively associated with opioid therapy.
Pain is prevalent among community-dwelling, ethnic Chinese American cancer patients. Additional studies are needed to confirm these results and investigate the finding that higher linguistic acculturation is associated with reports of more intense pain.
目前对于美籍华裔人群中的癌症疼痛知之甚少。本研究旨在描述这一人群的疼痛流行病学情况。了解这些信息对于确定和解决在文化上相关的疼痛干预措施方面尚未满足的临床需求具有重要意义。
在一家大型社区肿瘤学实践中，对服务不足的亚裔美籍患者进行连续筛查，以评估其是否存在持续性或频繁性疼痛。对于存在疼痛的患者，使用翻译后的评估工具来评估人口统计学特征、语言文化适应、疾病相关特征和疼痛相关特征。
在筛查的 312 名患者中，178 名（57.1%）报告存在频繁或持续性疼痛，175 名符合纳入标准，其中 170 名患者参与了研究。大多数参与者（85.9%）出生在中国，84.7%的患者只会说粤语。最常见的癌症为胃肠道癌（28.2%）、肺癌（21.8%）、乳腺癌（20.6%）、头颈部癌（12.9%）和泌尿生殖系统癌（4.7%）；43.5%的患者存在转移性疾病。0-10 数字评分法评估的平均最差疼痛严重程度为 4.7（标准差 2.4），28.2%的患者将其最差疼痛评为 10 分中的≥7 分。尽管 37.6%的患者使用阿片类药物，47.1%的患者使用非阿片类药物，但 45.8%的患者报告称药物对疼痛的缓解作用“较小”或“没有”。35.8%的患者使用了癌症疼痛的补充或替代医学疗法。在多元回归分析中，最差疼痛与英语语言文化适应呈正相关，与阿片类药物治疗呈正相关，疼痛相关的痛苦与阿片类药物治疗呈正相关。
在居住于社区的亚裔美籍癌症患者中，疼痛较为普遍。需要进一步的研究来证实这些结果，并调查语言文化适应程度较高与报告疼痛强度增加的发现。
