Dantigny Raphaëlle, Tanty Arnaud, Fourneret Philippe, Genin Nicolas, Bayet-Papin Béatrice, Mousseau Mireille, Hau Desbat Ngoc-Hanh
Centre hospitalier Métropole Savoie, service de radiothérapie, place Lucien-Biset, 73000 Chambéry, France.
Centre hospitalier Métropole Savoie, service de pharmacie hospitalière, unité de reconstruction centralisée des cytotoxiques (URCC), place Lucien-Biset, 73000 Chambéry, France.
Bull Cancer. 2018 Dec;105(12):1183-1192. doi: 10.1016/j.bulcan.2018.08.011. Epub 2018 Oct 23.
To assess pain prevalence, its features and its management in a radiotherapy department of a French public general hospital. To highlight strategies to improve pain screening and treatment.
Designed in conjunction with pain management specialists, a cross-sectional study on pain was carried out. All patients treated in the department being interviewed with a standardised questionnaire during 2 days.
Among 91 patients, 63.7% reported pain in daily life. They respectively represented 100%, 85.7% and 83.3% all of the patients treated for brain tumours, for bone metastasis and for head and neck cancers. Only 7.7% of patients reported pain during radiotherapy sessions. Among patients reporting pain, 70.7% received pain relief treatment and 60.8% of them thought this was adequate. While 51.6% of patients knew there was a specialist pain unit in the hospital, only 5.5% were offered a consultation with it. This unit provides non-pharmacological pain management techniques.
This study confirms the importance, the underestimation and undertreatment, of pain management in radiotherapy departments. We recommend using a standardised questionnaire to identify patients at highest risk of pain, and the use of specialised pain relief teams when needed. A radiation therapist could act as a referrer to the pain relief team. Pain management remains teamwork, with links to specialised units.
评估法国一家公立综合医院放疗科的疼痛发生率、疼痛特征及其管理情况。强调改善疼痛筛查和治疗的策略。
与疼痛管理专家联合设计,开展了一项关于疼痛的横断面研究。在两天内,对该科室所有接受治疗的患者进行标准化问卷调查。
在91名患者中,63.7%报告在日常生活中有疼痛。这些患者分别占所有接受脑肿瘤、骨转移和头颈癌治疗患者的100%、85.7%和83.3%。只有7.7%的患者报告在放疗期间有疼痛。在报告有疼痛的患者中,70.7%接受了止痛治疗,其中60.8%的患者认为治疗是充分的。虽然51.6%的患者知道医院设有专门的疼痛科,但只有5.5%的患者获得了该科室的会诊机会。该科室提供非药物疼痛管理技术。
本研究证实了放疗科疼痛管理的重要性、被低估的程度以及治疗不足的情况。我们建议使用标准化问卷来识别疼痛风险最高的患者,并在需要时使用专门的止痛团队。放射治疗师可以作为向止痛团队的转诊人。疼痛管理仍然是团队合作,与专门科室建立联系。