Posternak Victoria, Dunn Laura B, Dhruva Anand, Paul Steven M, Luce Judith, Mastick Judy, Levine Jon D, Aouizerat Bradley E, Hammer Marylin, Wright Fay, Miaskowski Christine
Department of Physiological Nursing, School of Nursing, University of California, CA, USA Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA Department of Medicine, School of Medicine, University of California, San Francisco, CA, USA Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York, NY School of Nursing, New York University, New York, NY Division of Acute Care/Health Systems, College of Nursing, Yale University, New Haven, CT, USA.
Pain. 2016 Apr;157(4):892-900. doi: 10.1097/j.pain.0000000000000456.
The purposes of this study, in oncology outpatients receiving chemotherapy (n = 926), were to: describe the occurrence of different types of pain (ie, no pain, only noncancer pain [NCP], only cancer pain [CP], or both CP and NCP) and evaluate for differences in demographic, clinical, and symptom characteristics, and quality of life (QOL) among the 4 groups. Patients completed self-report questionnaires on demographic and symptom characteristics and QOL. Patients who had pain were asked to indicate if it was or was not related to their cancer or its treatment. Medical records were reviewed for information on cancer and its treatments. In this study, 72.5% of the patients reported pain. Of the 671 who reported pain, 21.5% reported only NCP, 37.0% only CP, and 41.5% both CP and NCP. Across the 3 pain groups, worst pain scores were in the moderate to severe range. Compared with the no pain group, patients with both CP and NCP were significantly younger, more likely to be female, have a higher level of comorbidity, and a poorer functional status. In addition, these patients reported: higher levels of depression, anxiety, fatigue, and sleep disturbance; lower levels of energy and attentional function; and poorer QOL. Patients with only NCP were significantly older than the other 3 groups. The most common comorbidities in the NCP group were back pain, hypertension, osteoarthritis, and depression. Unrelieved CP and NCP continue to be significant problems. Oncology outpatients need to be assessed for both CP and NCP conditions.
本研究针对接受化疗的肿瘤门诊患者(n = 926),目的如下:描述不同类型疼痛(即无疼痛、仅存在非癌性疼痛[NCP]、仅存在癌性疼痛[CP]或同时存在CP和NCP)的发生情况,并评估这4组患者在人口统计学、临床和症状特征以及生活质量(QOL)方面的差异。患者完成了关于人口统计学和症状特征以及QOL的自我报告问卷。有疼痛的患者被要求指出疼痛是否与他们的癌症或其治疗相关。查阅病历以获取有关癌症及其治疗的信息。在本研究中,72.5%的患者报告有疼痛。在报告有疼痛的671名患者中,21.5%仅报告NCP,37.0%仅报告CP,41.5%同时报告CP和NCP。在这3个疼痛组中,最严重疼痛评分处于中度至重度范围。与无疼痛组相比,同时患有CP和NCP的患者明显更年轻,更可能为女性,合并症水平更高,功能状态更差。此外,这些患者报告:抑郁、焦虑、疲劳和睡眠障碍水平更高;精力和注意力功能水平更低;生活质量更差。仅患有NCP的患者比其他3组明显年龄更大。NCP组最常见的合并症是背痛、高血压、骨关节炎和抑郁。未缓解的CP和NCP仍然是严重问题。肿瘤门诊患者需要同时接受CP和NCP情况的评估。