Anshabo Abel Tesfaye, Migbaru Sefinew, Awoke Dagmawit, Tigeneh Wondemagegnhu, Engidawork Ephrem
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
Pain Pract. 2017 Nov;17(8):1023-1031. doi: 10.1111/papr.12557. Epub 2017 Mar 3.
Pain is a highly prevalent and distressing symptom in patients with cancer but at the same time inadequately treated in many of these patients. The major reason for such imbalance is inappropriate pain assessment. To overcome such a barrier, the use of a valid and reliable pain assessment tool in the language the patient understands is invaluable. Unfortunately, until now, no such standardized tool has been utilized in Ethiopian patients with cancer for both clinical and research purposes.
This study tried to validate the Amharic language version of the Brief Pain Inventory (BPI-Am) and evaluate the adequacy of cancer pain management using the Pain Management Index (PMI).
A standard forward/backward translation technique was used for translating the BPI from its original English version into Amharic (BPI-Am). The BPI-Am was administered to 291 Ethiopian patients with cancer who fulfilled the inclusion criteria. Factor analysis was used to identify the underlying constructs of the tool. Mean comparison was used to confirm the sensitivity of the BPI-Am to known patient groups that differed based on their performance status. Cronbach's α and intraclass correlation coefficients, respectively, were used to assure internal consistency and test-retest reliability of the BPI-Am. The PMI was calculated to identify the level of inadequate pain management in the current sample. Stepwise logistic regression was used to identify potential predictors of inadequate pain management.
Factor analysis yielded 3 factors-pain severity, physical activity interference, and psychosocial interference-with Cronbach's α coefficients of 0.85, 0.87, and 0.77, respectively. The BPI-Am showed the capacity to detect higher mean pain severity and mean pain interference scores in patients with poor performance status as compared with those having a good performance status (P < 0.001). Intraclass correlation coefficients for test-retest reliability were 0.75 and 0.78 for the pain severity and pain interference composite scores, respectively. Sixty-seven percent of patients in the current sample were inadequately treated for their pain according to the PMI. Good performance status (odds ratio [OR] = 2.9, P < 0.01), absence of cancer-related complications (OR = 2.1, P < 0.05), and being unemployed (OR = 2.6, P < 0.01) were identified as predictors of inadequate pain management.
The BPI-Am is a valid and reliable tool for use in Ethiopian patients with cancer. The inadequacy of cancer pain management in these groups of patients is high, which calls for needed attention.
疼痛是癌症患者中一种非常普遍且令人痛苦的症状，但与此同时，许多此类患者的疼痛治疗并不充分。这种失衡的主要原因是疼痛评估不当。为了克服这一障碍，使用患者能理解的语言的有效且可靠的疼痛评估工具非常重要。不幸的是，到目前为止，埃塞俄比亚癌症患者尚未将此类标准化工具用于临床和研究目的。
本研究试图验证阿姆哈拉语版简明疼痛问卷（BPI-Am），并使用疼痛管理指数（PMI）评估癌症疼痛管理的充分性。
采用标准的正向/反向翻译技术将BPI从其原始英语版本翻译成阿姆哈拉语（BPI-Am）。BPI-Am被施用于291名符合纳入标准的埃塞俄比亚癌症患者。因子分析用于识别该工具的潜在结构。均值比较用于确认BPI-Am对基于其表现状态而不同的已知患者群体的敏感性。分别使用Cronbach's α和组内相关系数来确保BPI-Am的内部一致性和重测信度。计算PMI以识别当前样本中疼痛管理不充分的程度。逐步逻辑回归用于识别疼痛管理不充分的潜在预测因素。
因子分析产生了3个因子——疼痛严重程度、身体活动干扰和心理社会干扰——Cronbach's α系数分别为0.85、0.87和0.77。与表现状态良好的患者相比，BPI-Am显示出能够检测出表现状态较差的患者更高的平均疼痛严重程度和平均疼痛干扰得分（P < 0.001）。疼痛严重程度和疼痛干扰综合得分的重测信度组内相关系数分别为0.75和0.78。根据PMI，当前样本中67%的患者疼痛治疗不充分。表现状态良好（优势比[OR]=2.9，P < 0.01）、无癌症相关并发症（OR=2.1，P < 0.05）和失业（OR=2.6，P < 0.01）被确定为疼痛管理不充分的预测因素。
BPI-Am是用于埃塞俄比亚癌症患者的有效且可靠的工具。这些患者群体中癌症疼痛管理不充分的情况很严重，需要引起关注。
