Yu Shi-Ying, Wang Jie-Jun, Huang Yu-Guang, Hu Bing, Wang Kun, Li Ping Ping, Wu Yi-Long, Zhang He-Long, Zhang Li, Zhang Qing-Yuan, Qin Shu-Kui
, Huazhong University of Science and Technology and Tongji Hospital, Wuhan; , Shanghai Changzheng Hospital, Shanghai; , Peking Union Medical College Hospital; , Beijing University Cancer Hospital, Beijing; , Anhui Provincial Hospital, Anhui; , Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin; , Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong; , Tangdu Hospital and Tangdu Comprehensive Cancer Center, Cancer Institute, 4th Military Medical University, Xi'an; , Sun Yat-Sen University Cancer Center, Guangzhou; , 3rd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang; and , The People's Liberation Army Cancer Centre, Nanjing Bayi Hospital, Nanjing, Jiangsu, People's Republic of China.
J Glob Oncol. 2016 Sep 21;3(5):583-595. doi: 10.1200/JGO.2016.005686. eCollection 2017 Oct.
The number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer.
We describe procedures for the selection, implementation, and assessment procedures for model cancer wards. We analyzed published results in areas of staff training and patient education, pain management in practice, analgesic drugs administration, and patient follow-up and satisfaction.
Pain management training enabled medical staff to accurately assess the level of pain and to provide effective pain relief through timely dispensation of medication. Patients with good knowledge of treatment of pain were able to overcome their aversion to opioid drugs and cooperate with nursing staff on pain assessment to achieve effective drug dose titration. Consumption of strong opioid drugs increased significantly; however, there was no change for weaker opioids. Higher pain remission rates were achieved for patients with moderate-to-severe pain levels. Proper patient follow-up after discharge enabled improved outcomes to be maintained.
The GPM program has instituted a consistent and high standard of care for pain management at cancer wards and improved the quality of life for patients with cancer.
中国的癌症病例数已从2000年的210万迅速增加到2015年的430万。因此，疼痛管理作为癌症治疗的一个组成部分成为一个重要的医疗保健问题。2011年3月，启动了良好疼痛管理（GPM）项目，以规范癌症疼痛治疗并改善癌症患者的生活质量。通过这项工作，我们将描述GPM项目、其实施经验，并强调可改善癌症患者疼痛管理的关键经验教训。
我们描述了示范癌症病房的选择、实施和评估程序。我们分析了在员工培训和患者教育、实践中的疼痛管理、镇痛药给药以及患者随访和满意度等方面已发表的结果。
疼痛管理培训使医务人员能够准确评估疼痛程度，并通过及时配药提供有效的疼痛缓解。对疼痛治疗有充分了解的患者能够克服对阿片类药物的厌恶，并与护理人员合作进行疼痛评估，以实现有效的药物剂量滴定。强阿片类药物的消耗量显著增加；然而，弱阿片类药物的消耗量没有变化。中重度疼痛患者的疼痛缓解率更高。出院后对患者进行适当的随访能够维持改善后的结果。
GPM项目在癌症病房建立了一致且高标准的疼痛管理护理，并改善了癌症患者的生活质量。
