Coyle N, Adelhardt J, Foley K M, Portenoy R K
J Pain Symptom Manage. 1990 Apr;5(2):83-93. doi: 10.1016/s0885-3924(05)80021-1.
There is a great variability among advanced cancer patients in the experience of symptoms and their impact on life's activities. A subgroup of difficult patients particularly tax the clinical skills and compassion of practitioners. Although the need for information about these patients is evident, their characteristics have not been explored heretofore. We describe our experience with such patients, a group referred to the Supportive Care Program of the Pain Service at Memorial Sloan-Kettering Cancer Center. Prevalence of pain and other symptoms, patterns of opioid use and routes of drug administration, and the prevalence of suicidal ideation and requests for euthanasia are discussed.
晚期癌症患者在症状体验及其对生活活动的影响方面存在很大差异。有一部分难缠的患者尤其考验从业者的临床技能和同情心。尽管显然需要了解这些患者的情况，但此前尚未对他们的特征进行探索。我们描述了我们对这类患者的经验，这是一组转诊至纪念斯隆 - 凯特琳癌症中心疼痛服务支持护理项目的患者。文中讨论了疼痛和其他症状的发生率、阿片类药物的使用模式和给药途径，以及自杀意念和安乐死请求的发生率。
