印度四家地区癌症医院疼痛及其管理的预测因素和患病率
Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India.
作者信息
Doyle Katherine E, El Nakib Shatha K, Rajagopal M R, Babu Sunil, Joshi Geeta, Kumarasamy Vidya, Kumari D Priya, Chaudhuri Prabir, Mohanthy Sumita, Jatua Debasish, Lohman Diederik, Amon Joseph J, Palat Gayatri
机构信息
Katherine E. Doyle and Shatha K. El Nakib, Columbia University Mailman School of Public Health; Diederik Lohman and Joseph J. Amon, Human Rights Watch, New York, NY; M.R. Rajagopal, Pallium India, Trivandrum, India; Vidya Kumarasamy, D. Priya Kumari, Gayatri Palat, and MNJ Institute of Oncology, Hyderabad, India; Geeta Joshi, Gujarat Cancer and Research Institute, Ahmedabad, India; Prabir Chaudhuri, no institution; Sumita Mohanthy, AHRCC, Cuttack, India; Debasish Jatua, Chittaranjan National Cancer Institute, Kolkata, India; and Sunil Babu, no institution.
出版信息
J Glob Oncol. 2018 Sep;4:1-9. doi: 10.1200/JGO.2016.006783. Epub 2017 Apr 13.
PURPOSE
More than 1 million new occurrences of cancer are diagnosed in India annually. Among patients with cancer, pain is a common and persistent symptom of the disease and its treatment. However, few studies to date have evaluated the prevalence of pain and the adequacy of pain management in Indian hospitals. This cross-sectional study aimed to assess the prevalence and sociodemographic patterns of cancer pain and pain management among a sample of inpatients and newly registered outpatients at four large regional cancer centers in India.
METHODS
A sample of 1,600 patients with cancer who were current inpatients or newly registered outpatients were recruited and administered a questionnaire that was based on the Brief Pain Inventory. The survey tool included questions on demographics, medical history, and extent of clinical pain experienced. In addition, a pain management index score was created to link the severity of cancer pain with medication prescribed to treat it.
RESULTS
A total of 88% of patients reported pain in the past 7 days, and approximately 60% reported that their worst pain was severe. Several demographic and medical characteristics of the study population predicted severe pain, including the following: lower educational level, outpatient status, and debt incurred as a result of illness. A total of 67% of patients were inadequately treated with analgesics. Inadequate pain management was associated with both treatment hospital and patient type, and patients who reported debt as a result of their illness were more likely to have inadequate pain management.
CONCLUSION
A majority of Indian patients with cancer experience significant pain and receive inadequate pain management. Improvement of pain management for Indian patients with cancer is needed urgently.
目的
印度每年有超过100万例新发癌症病例被诊断出来。在癌症患者中，疼痛是该疾病及其治疗过程中常见且持续存在的症状。然而，迄今为止，很少有研究评估印度医院中疼痛的患病率以及疼痛管理的充分性。这项横断面研究旨在评估印度四个大型区域癌症中心的住院患者和新登记门诊患者样本中癌症疼痛的患病率、社会人口学模式以及疼痛管理情况。
方法
招募了1600名癌症患者样本，他们为现住院患者或新登记门诊患者，并对其进行了基于简明疼痛量表的问卷调查。该调查工具包括有关人口统计学、病史以及所经历临床疼痛程度的问题。此外，还创建了一个疼痛管理指数评分，以将癌症疼痛的严重程度与用于治疗疼痛的药物联系起来。
结果
共有88%的患者报告在过去7天内经历过疼痛，约60%的患者报告其最严重的疼痛为重度疼痛。研究人群的几个人口统计学和医学特征预示着会出现重度疼痛，包括以下方面：教育水平较低、门诊患者身份以及因病产生的债务。共有67%的患者镇痛药物治疗不充分。疼痛管理不充分与治疗医院和患者类型均有关联，因病报告有债务的患者更有可能存在疼痛管理不充分的情况。
结论
大多数印度癌症患者经历着严重疼痛且疼痛管理不充分。迫切需要改善印度癌症患者的疼痛管理。
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