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满意或不满意:镰状细胞病患者的疼痛体验

Satisfied or not satisfied: pain experiences of patients with sickle cell disease.

作者信息

Ezenwa Miriam O, Molokie Robert E, Wang Zaijie Jim, Suarez Marie L, Yao Yingwei, Wilkie Diana J

机构信息

Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.

College of Medicine, University of Illinois at Chicago, Illinois, USA.

出版信息

J Adv Nurs. 2016 Jun;72(6):1398-408. doi: 10.1111/jan.12678. Epub 2015 Apr 27.

Abstract

AIMS

To examine the relationship between pain and satisfaction in patients with sickle cell disease.

BACKGROUND

Frequency and severity of unrelieved sickle cell pain are positively associated with mortality. Yet, information is scarce on whether sickle cell patients are satisfied with their pain level.

DESIGN

A cross-sectional, correlational analysis of baseline data from a randomized clinical trial.

METHODS

A randomized sample of adult outpatients was recruited between February 2007-March 2011. Patients completed the PAINReportIt(®) , containing measures of pain, satisfaction and socio-demographics. We analysed data using Kendall's rank correlations, analysis of variance, Tukey-Kramer post hoc tests, Fisher's tests and proportional odds logistic regression.

RESULTS

There were statistically significant correlations between pain outcomes and satisfaction with pain level, but average pain intensity more strongly discriminated groups based on satisfaction with pain level. Among pain variables bivariately associated with patient satisfaction with pain level, only pain expectation maintained its significant relationship with satisfaction with pain level when average pain intensity was controlled. A smaller percentage of our sickle cell patients reported moderate to severe pain intensity (28%) or high composite pain index (39%), while reporting being satisfied with pain their level than reported in earlier studies using different measures and populations (70-94%).

CONCLUSION

Satisfaction with pain level was an unambiguous measure of patient satisfaction and a promising indicator of pain that did not show the paradoxical relationship between satisfaction and pain seen with past measures.

摘要

目的

研究镰状细胞病患者疼痛与满意度之间的关系。

背景

镰状细胞疼痛未缓解的频率和严重程度与死亡率呈正相关。然而,关于镰状细胞病患者对其疼痛程度是否满意的信息却很少。

设计

对一项随机临床试验的基线数据进行横断面相关分析。

方法

在2007年2月至2011年3月期间招募了成年门诊患者的随机样本。患者完成了PAINReportIt(®),其中包含疼痛、满意度和社会人口统计学指标。我们使用肯德尔等级相关性分析、方差分析、图基-克雷默事后检验、费舍尔检验和比例优势逻辑回归分析数据。

结果

疼痛结果与对疼痛程度的满意度之间存在统计学上的显著相关性,但平均疼痛强度在根据对疼痛程度的满意度区分组别方面表现得更为明显。在与患者对疼痛程度的满意度双变量相关的疼痛变量中,当控制平均疼痛强度时,只有疼痛预期与对疼痛程度的满意度保持显著关系。与使用不同测量方法和人群的早期研究(70%-94%)相比,我们的镰状细胞病患者中报告中度至重度疼痛强度(28%)或高综合疼痛指数(39%)但表示对其疼痛程度满意的比例更小。

结论

对疼痛程度的满意度是患者满意度的一个明确指标,也是一个有前景的疼痛指标,它没有显示出过去测量方法中所见的满意度与疼痛之间的矛盾关系。

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