Hameed Khaled Abdel
Pain Management Unit, National Cancer Institute, Cairo University, Cairo, Egypt.
J Pediatr Hematol Oncol. 2011 Apr;33 Suppl 1:S19-22. doi: 10.1097/MPH.0b013e3182121a45.
As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. Pain clinics of cancer are committed to helping patients and families identify and implement the treatments necessary to achieve optimum functional ability and the best possible quality of life. These clinics also help to communicate and work with the family physician, surgeon, and other physicians associated with patient treatment. Cancer pain is complex in its causes, and affects all parts of the body. It involves the tissues, body systems , and the mind. Being multidimensional, it is never adequately addressed with unidimensional treatment. Pain management must extend beyond physical approaches to include the psychological, social, and even spiritual aspects of the patient. Effective integrated treatment fosters self awareness and teaches appropriate and effective self care. With time, complex issues are managed, pain is reduced, and the patient moves toward peak physical and psychological functioning. These goals can be achieved by providing the highest quality pain management services. Patients attending the clinic get treated medically for their physical ailments. Their emotional and psychological problems also need to be attended with an atmosphere of love and care. The mission of the highest quality service is to obtain customer satisfaction with reduction of cost in a multidisciplinary (or better interdisciplinary) approach. This can be reached by proper identification of the customers either internal or external, assessing their needs, and implementing plans for their satisfaction. In addition, monitoring the improvement of such plans is an integral part of the quality process. Importantly, the facility provides comprehensive care with professionals available 24 hours/7 days. On-call teams assigned to manage pain and other treatment modalities comprises of staff supervised by the primary cancer clinicians; this arrangement facilitates reaching this goal. This study will illustrate our experience through 25 years, trying to provide the highest care of patients with cancer pain on an outpatient basis.
由于开罗国家癌症研究所患者的等待名单不断增加，我们面临着通过门诊疼痛诊所提供高质量疼痛护理服务的任务。此处呈现的项目描述展示了每周7天、每天24小时的门诊癌症疼痛管理服务为患有复杂疼痛和姑息治疗症状负担的患者提供快速可及的高质量护理的能力。此外，这种模式避免了患者住院。癌症疼痛诊所致力于帮助患者及其家属识别并实施必要的治疗，以实现最佳功能能力和尽可能好的生活质量。这些诊所还协助与家庭医生、外科医生以及与患者治疗相关的其他医生进行沟通与合作。癌症疼痛的成因复杂，会影响身体的各个部位。它涉及组织、身体系统以及心理层面。由于具有多维度性，单一维度的治疗方法永远无法充分解决该问题。疼痛管理必须超越物理方法，涵盖患者的心理、社会乃至精神层面。有效的综合治疗能增强自我意识，并教授恰当且有效的自我护理方法。随着时间推移，复杂问题得到解决，疼痛减轻，患者的身体和心理功能朝着最佳状态发展。通过提供最高质量的疼痛管理服务可以实现这些目标。到诊所就诊的患者会因其身体疾病接受药物治疗。他们的情感和心理问题也需要在充满爱与关怀的氛围中得到关注。最高质量服务的使命是以多学科（或更佳的跨学科）方法在降低成本的同时获得客户满意度。这可以通过正确识别内部或外部客户、评估他们的需求以及实施满足他们需求的计划来实现。此外，监测此类计划的改进是质量过程不可或缺的一部分。重要的是，该机构提供全面护理，专业人员每周7天、每天24小时随时待命。负责管理疼痛和其他治疗方式的随叫随到团队由在初级癌症临床医生监督下的工作人员组成；这种安排有助于实现这一目标。本研究将阐述我们25年来的经验，即在门诊基础上努力为癌症疼痛患者提供最高水平的护理。
