European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Trondheim University Hospital, Trondheim, Norway.
Support Care Cancer. 2012 Oct;20(10):2491-500. doi: 10.1007/s00520-011-1361-z. Epub 2012 Jan 18.
Patients' involvement in the development of assessment tools is recommended, and the European Palliative Care Research Collaborative has adhered to this when developing a shared language for cancer pain, an international assessment and classification system. Study objectives were to investigate how patients ranked the relevance of several previously identified pain domains, to investigate patients' perception of the pain experience and to disclose additional, relevant pain domains for cancer pain classification to those identified in the literature.
Semistructured interviews with advanced cancer patients treated with opioids were performed and analysed verbatim. Patients scored the relevance of predefined pain domains on an 11-point Numerical Rating Scale.
Thirty-three Norwegian and Austrian patients were included (16 females and 17 males); the mean age was 63 years, and the mean Karnofsky performance score was 65. The ranking of domains was as follows etiology (mean Numerical Rating Scale score, 8.5), duration (8.0), intensity (7.4), coping (7.1), physical (5.9) and psychological functioning (5.8). Sleep was identified as a new candidate domain to include in the system. The patients emphasised consequences of having pain, for example, poor physical functioning and psychological distress.
Previously identified pain domains were confirmed to be relevant to the patients; however, the ranking differed from the experts' ranking. Sleep disturbances may be added as a domain in a future classification system.
建议患者参与评估工具的开发，欧洲姑息治疗研究协作组在制定癌症疼痛的通用语言、国际评估和分类系统时就遵循了这一原则。本研究旨在调查患者对先前确定的几个疼痛领域的相关性的排名情况，了解患者对疼痛体验的感知，并发现癌症疼痛分类中除文献中已确定的其他相关疼痛领域。
对接受阿片类药物治疗的晚期癌症患者进行半结构化访谈，并进行逐字分析。患者对预先设定的疼痛领域的相关性进行 11 点数字评分量表评分。
共纳入 33 名挪威和奥地利患者（女性 16 名，男性 17 名）；平均年龄为 63 岁，Karnofsky 表现评分为 65 分。各领域的排名如下：病因（平均数字评分量表评分 8.5）、持续时间（8.0）、强度（7.4）、应对（7.1）、身体（5.9）和心理功能（5.8）。睡眠被确定为新的候选领域纳入该系统。患者强调了疼痛的后果，例如身体功能不佳和心理困扰。
先前确定的疼痛领域被证实与患者相关，但排名与专家的排名不同。未来的分类系统中可能会增加睡眠障碍这一领域。
