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乳腺癌治疗前女性的压痛表型

Pressure Pain Phenotypes in Women Before Breast Cancer Treatment.

作者信息

Kanzawa-Lee Grace A, Harte Steven E, Bridges Celia M, Brummett Chad, Clauw Daniel J, Williams David A, Knoerl Robert, Lavoie Smith Ellen M

机构信息

University of Michigan.

Dana-Farber Cancer Institute.

出版信息

Oncol Nurs Forum. 2018 Jul 2;45(4):483-495. doi: 10.1188/18.ONF.483-495.

Abstract

OBJECTIVES

To explore associations between quantitative sensory testing (QST) and pretreatment pain, physical, and psychological characteristics in women with breast cancer.

SAMPLE & SETTING: 41 women with treatment-naive stage 0-III breast cancer at the University of Michigan Comprehensive Cancer Center in Ann Arbor.

METHODS & VARIABLES: Participants completed self-report surveys and QST within the month before breast surgery. Pressure pain thresholds (PPTs) were measured bilaterally at each trapezius with a manual QST algometer. PPT values were split, yielding low, moderate, and high pain sensitivity subgroups. Subgroup self-reported characteristics were compared using Spearman's correlation, chi-square, and one-way analysis of variance.

RESULTS

Lower PPT (higher sensitivity) was associated with higher levels of pain interference and maladaptive pain cognitions. The high-sensitivity group reported higher pain severities, interference, and catastrophizing and lower belief in internal locus of pain control than the low-sensitivity group.

IMPLICATIONS FOR NURSING

Individualized interventions for maladaptive pain cognitions before surgery may reduce pain sensitivity and the severity of chronic pain developed after surgery.

摘要

目的

探讨定量感觉测试(QST)与乳腺癌女性患者治疗前疼痛、身体及心理特征之间的关联。

样本与研究背景

41名未接受过治疗的0-III期乳腺癌女性患者,来自安阿伯市密歇根大学综合癌症中心。

方法与变量

参与者在乳房手术前一个月内完成了自我报告调查和QST。使用手动QST测痛仪双侧测量每个斜方肌的压痛阈值(PPTs)。PPT值被划分,产生低、中、高疼痛敏感性亚组。使用Spearman相关性分析、卡方检验和单因素方差分析比较亚组的自我报告特征。

结果

较低的PPT(较高的敏感性)与较高水平的疼痛干扰和适应不良的疼痛认知相关。高敏感性组比低敏感性组报告了更高的疼痛严重程度、干扰和灾难化思维,以及更低的对疼痛内控点的信念。

对护理的启示

术前针对适应不良疼痛认知的个体化干预可能会降低疼痛敏感性以及术后发生慢性疼痛的严重程度。

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