Department of Hematology and Oncology, Ulsan University College of Medicine and Ulsan University Hospital, Ulsan, Republic of Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Pain Med. 2018 Dec 1;19(12):2546-2555. doi: 10.1093/pm/pny039.
More than half of the patients have reported improper management of breakthrough cancer pain. Empirical evidence is lacking concerning the effectiveness of cancer pain education on breakthrough pain control. This study aimed to examine the effects of individual pain education on pain control, use of short-acting analgesics for breakthrough pain, quality of life outcomes, and rectification of patients' misconceptions regarding cancer pain.
A quasi-experimental design was used. In total, 176 (102 inpatients and 74 outpatients) and 163 (93 inpatients and 70 outpatients) cancer patients completed questionnaires on pain intensity, quality of life, use of short-acting medication for breakthrough pain, and misconceptions about cancer pain and opioid use before and immediately and/or seven days after individual pain education.
The mean age of the participants was 60.9 years (±11.2), and 56.3% were male. The most common cancers were lung cancer (17.0%), colon cancer (15.9%), and breast cancer (12.5%). The subjects' reasons for attrition were conditional deterioration, death, or voluntary withdrawal (N = 13, 7.4%). Following the education, there was a significant reduction in overall pain intensity over 24 hours (P < 0.001). The outpatients showed more use of short-acting analgesics for breakthrough pain. Sleep quality change was most significantly associated with intervention; other quality of life aspects (e.g., general feelings and life enjoyment) also improved. Pain education also significantly reduced misconceptions regarding cancer pain management.
The present educational intervention was effective in encouraging short-acting analgesic use for breakthrough pain, improving quality of life outcomes, and rectifying patients' misconceptions about analgesic use.
超过一半的患者报告称突破性癌痛管理不当。缺乏关于癌症疼痛教育对突破性疼痛控制效果的经验证据。本研究旨在检验个体疼痛教育对疼痛控制、短期缓解药物用于突破性疼痛、生活质量结局以及纠正患者对癌症疼痛和阿片类药物使用的误解的影响。
采用准实验设计。共有 176 名(102 名住院患者和 74 名门诊患者)和 163 名(93 名住院患者和 70 名门诊患者)癌症患者在接受个体疼痛教育之前、之后立即和/或七天后完成了关于疼痛强度、生活质量、短期缓解药物用于突破性疼痛以及对癌症疼痛和阿片类药物使用的误解的问卷。
参与者的平均年龄为 60.9 岁(±11.2),56.3%为男性。最常见的癌症是肺癌(17.0%)、结肠癌(15.9%)和乳腺癌(12.5%)。受试者失访的原因是病情恶化、死亡或自愿退出(N=13,7.4%)。教育后,24 小时内总体疼痛强度显著降低(P<0.001)。门诊患者更频繁地使用短期缓解药物治疗突破性疼痛。睡眠质量变化与干预最显著相关;其他生活质量方面(如一般感觉和生活享受)也有所改善。疼痛教育也显著减少了对癌症疼痛管理的误解。
本教育干预措施有效鼓励了短期缓解药物用于突破性疼痛,改善了生活质量结局,并纠正了患者对镇痛药物使用的误解。