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“我们都在谈论它,好像我们在思考同一件事。” 癌症晚期疼痛管理中医疗保健专业人员的目标:一项定性研究。

"We all talk about it as though we're thinking about the same thing." Healthcare professionals' goals in the management of pain due to advanced cancer: a qualitative study.

出版信息

Support Care Cancer. 2014 Aug;22(8):2067-73. doi: 10.1007/s00520-014-2191-6. Epub 2014 Mar 15.

Abstract

PURPOSE

Unfortunately, several barriers impede successful management of cancer pain including those relating to the assessment and measurement of pain. There is currently no consensus as to what constitutes good pain control or what healthcare professionals are aiming to achieve in the management of pain for patients with advanced cancer. This study aimed to explore healthcare professionals' views and experiences to elicit what they are aiming to achieve in managing pain for patients with advanced cancer.

METHODS

Healthcare professionals involved in the management of cancer pain were sampled purposively and interviewed using a semi-structured interview technique until saturation of data. Data were analysed using the constant comparison approach.

RESULTS

Sixteen interviews took place and four main themes emerged: aims of pain management, assessing response to pain management, managing expectations, and building relationships. Healthcare professionals found assessing patients' pain challenging and reported that patients had difficulty using numerical rating scales. Healthcare professionals used different terms when talking about managing pain, such as 'pain control' but found it difficult to define these terms. Maintaining patients' function and managing their expectations were described as important. However, it was not always clear whether the patient goals mentioned were voiced explicitly by the patient or assumed by the healthcare professional.

CONCLUSION

Healthcare professionals described what they deemed important in the management of pain. The goals they mentioned almost exclusively related to function as opposed to pain scores, but patients' goals and expectations were often not elicited specifically.

摘要

目的

不幸的是,有几个障碍会妨碍癌症疼痛的成功管理,包括与疼痛评估和测量有关的障碍。目前,对于什么是良好的疼痛控制,以及医疗保健专业人员在管理晚期癌症患者的疼痛时旨在实现什么,还没有达成共识。本研究旨在探讨医疗保健专业人员的观点和经验,以了解他们在管理晚期癌症患者疼痛方面的目标。

方法

采用目的抽样法对参与癌症疼痛管理的医疗保健专业人员进行抽样,并采用半结构化访谈技术对其进行访谈,直至数据饱和。采用恒比法对数据进行分析。

结果

共进行了 16 次访谈,出现了 4 个主要主题:疼痛管理的目标、评估疼痛管理的反应、管理期望和建立关系。医疗保健专业人员发现评估患者的疼痛具有挑战性,并报告说患者在使用数字评分量表时存在困难。医疗保健专业人员在谈论疼痛管理时使用了不同的术语,例如“疼痛控制”,但发现很难定义这些术语。保持患者的功能和管理他们的期望被描述为重要的。然而,并不总是清楚患者提到的目标是由患者明确表达的,还是由医疗保健专业人员假设的。

结论

医疗保健专业人员描述了他们认为在疼痛管理中重要的内容。他们提到的目标几乎完全与功能相关,而不是与疼痛评分相关,但患者的目标和期望通常没有被具体引出。

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