Lim Sung-Nam, Han Hye-Sook, Lee Ki-Hyeung, Lee Sang-Cheol, Kim JungHan, Yun JiNa, Park SongGon, Park MinJae, Choe YoonHee, Ryoo Hun-Mo, Lee KyungHee, Cho DoYeun, Zang Dae Young, Choi JinHo
1 Department of Internal Medicine, Haeundae-Paik Hospital, College of Medicine Inje University , Busan, South Korea .
J Palliat Med. 2015 Mar;18(3):225-31. doi: 10.1089/jpm.2014.0021. Epub 2015 Feb 4.
Pain is one of the most common and distressing symptoms in patients with cancer, with a high prevalence of 90%. Appropriate pain assessment is very important in managing cancer pain.
The aims of this study were to (1) evaluate patient satisfaction with pain control therapy using a self-reporting pain assessment tool, (2) explore the usefulness of a self-reporting assessment tool for patients and physicians, and (3) evaluate patient perception of pain management and opioid analgesics.
We enrolled a total of 587 South Korean adult cancer patients hospitalized for five days or more. Pain assessment using a self-reporting pain assessment tool was performed by patients themselves from Day 1 to Day 5. The average pain intensity on a numeric rating scale (NRS) and the frequency of breakthrough pain between Day 1 and Day 5 were recorded with a self-reporting pain assessment tool. We evaluated patient satisfaction with pain control and the usefulness of a self-reporting pain assessment tool for patients and physicians on Day 5.
Among the 587 enrolled patients, 551, excluding 36 patients who violated inclusion criteria, were analyzed. The pain satisfaction rate was 79.5%, and only 6.2% of assessed patients had a negative pain management index (PMI). However, symmetry analysis for pain intensity between patient and physician showed low agreement (kappa=0.21). The patients with dissatisfaction for cancer pain control expressed negative attitudes toward using opioid analgesics and misconceptions regarding pain management. The satisfaction for using a self-reporting pain assessment tool was 79.2% in patients and 86.4% in physicians, respectively.
The use of a self-reporting pain assessment tool as a communication instrument provides an effective foundation for evaluating pain intensity in cancer pain management. A more individualized approach to patient education about pain management may improve patient outcome.
疼痛是癌症患者最常见且令人痛苦的症状之一，患病率高达90%。恰当的疼痛评估对于癌症疼痛管理非常重要。
本研究的目的是：（1）使用自我报告疼痛评估工具评估患者对疼痛控制治疗的满意度；（2）探索自我报告评估工具对患者和医生的有用性；（3）评估患者对疼痛管理和阿片类镇痛药的认知。
我们共纳入了587名住院5天及以上的韩国成年癌症患者。患者在第1天至第5天使用自我报告疼痛评估工具进行疼痛评估。使用自我报告疼痛评估工具记录数字评分量表（NRS）上第1天至第5天的平均疼痛强度以及爆发性疼痛的频率。我们在第5天评估患者对疼痛控制的满意度以及自我报告疼痛评估工具对患者和医生的有用性。
在587名纳入患者中，排除36名违反纳入标准的患者后，对551名患者进行了分析。疼痛满意度为79.5%，仅6.2%的评估患者疼痛管理指数（PMI）为阴性。然而，患者与医生之间疼痛强度的对称性分析显示一致性较低（kappa = 0.21）。对癌症疼痛控制不满意的患者对使用阿片类镇痛药持消极态度，且对疼痛管理存在误解。患者对使用自我报告疼痛评估工具的满意度为79.2%，医生为86.4%。
使用自我报告疼痛评估工具作为沟通手段为评估癌症疼痛管理中的疼痛强度提供了有效的基础。采用更个性化的方法对患者进行疼痛管理教育可能会改善患者的治疗效果。
