Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea.
J Palliat Med. 2012 Nov;15(11):1222-33. doi: 10.1089/jpm.2012.0183. Epub 2012 Sep 13.
Pain is common during cancer treatment, and patient self-reporting of pain is an essential first step for ideal cancer pain management. However, many studies on cancer pain management report that, because pain may be underestimated, it is often inadequately managed.
The aim of this study was to evaluate the effectiveness of bedside self-assessment of pain intensity for inpatients using a self-reporting pain board.
Fifty consecutive inpatients admitted to the Oncology Department of Chungbuk National University Hospital were included in this observational prospective study from February 2011 to December 2011. The medical staff performed pain assessments by asking patients questions and using verbal rated scales (VRS) over 3 consecutive days. Then, for 3 additional days, patients used a self-reporting pain board attached to the bed, which had movable indicators representing 0-10 on a numeric rating scale (NRS) and the frequency of breakthrough pain.
Patient reliability over the medical staff's pain assessment increased from 74% to 96% after applying the self-reporting pain board (p=0.004). The gap (mean±standard deviation [SD]) between the NRS reported by patients and the NRS recorded on the medical records decreased from 3.16±2.08 to 1.00±1.02 (p<0.001), and the level of patient satisfaction with pain management increased from 54% to 82% (p=0.002).
This study suggests that the self-reporting bedside pain assessment tool provides a reliable and effective means of assessing pain in oncology inpatients.
疼痛在癌症治疗过程中很常见，患者对疼痛的自我报告是理想的癌症疼痛管理的第一步。然而，许多癌症疼痛管理的研究报告称，由于疼痛可能被低估，因此往往管理不足。
本研究旨在评估使用自我报告疼痛板对住院患者进行床边自我评估疼痛强度的效果。
2011 年 2 月至 2011 年 12 月，我们对连续入住忠北国立大学医院肿瘤内科的 50 例住院患者进行了这项观察性前瞻性研究。医务人员在连续 3 天通过询问患者问题并使用口头评定量表（VRS）进行疼痛评估。然后，在接下来的 3 天，患者使用附在床旁的自我报告疼痛板，该板上有表示数字评定量表（NRS）0-10 的可移动指标和爆发性疼痛的频率。
使用自我报告疼痛板后，患者对医务人员疼痛评估的可靠性从 74%提高到 96%（p=0.004）。患者报告的 NRS 与病历记录的 NRS 之间的差距（平均值±标准偏差 [SD]）从 3.16±2.08 降至 1.00±1.02（p<0.001），患者对疼痛管理的满意度从 54%提高到 82%（p=0.002）。
本研究表明，床边自我报告疼痛评估工具为评估肿瘤内科住院患者的疼痛提供了一种可靠有效的方法。
