University of Florida.
University of Iowa.
Oncol Nurs Forum. 2020 Mar 1;47(2):228-240. doi: 10.1188/20.ONF.228-240.
To investigate racial differences in implementation of 11 evidence-based cancer pain management strategies in a matched sample of patients in hospice.
SAMPLE & SETTING: 32 African American and 32 Caucasian American older adults (aged 65 years or older) with cancer pain receiving hospice care in the midwestern United States.
METHODS & VARIABLES: Matched cohort secondary data analysis of postintervention data in a cluster randomized controlled trial was used. Main outcomes are the summative and individual Cancer Pain Practice Index scores.
There were few statistically significant or clinically meaningful differences in implementation of individual best practices for pain management by race. Assessment of primary pain characteristics and management of opioid-induced constipation with a bowel regimen was significantly lower in African Americans than in Caucasian Americans.
African American older adults receiving hospice care at the end of life received pain management that was, overall, comparable to matched Caucasian American older adults. Hospice and oncology nurses play a critical role in effective pain management and should continue to implement evidence-based guidelines for pain management into daily practice. Diffusing the hospice model and principles of pain and symptom management into other settings and specialty care areas may reduce widespread pain disparities.
在匹配的临终关怀癌症疼痛患者样本中，调查种族差异对 11 种循证癌症疼痛管理策略的实施情况。
32 名非裔美国人和 32 名白种美国老年人（年龄在 65 岁及以上）患有癌症疼痛，在美国中西部接受临终关怀。
使用了一项集群随机对照试验的干预后数据的匹配队列二次数据分析。主要结果是总结性和个体癌症疼痛实践指数评分。
在实施疼痛管理的个别最佳实践方面，种族之间几乎没有统计学上显著或临床上有意义的差异。与白种美国人相比，非裔美国人对主要疼痛特征的评估以及使用肠道方案管理阿片类药物引起的便秘明显较低。
接受临终关怀的非裔美国老年人在生命末期接受的疼痛管理总体上与匹配的白种美国老年人相当。临终关怀和肿瘤护士在有效疼痛管理中发挥着关键作用，应继续将循证疼痛管理指南纳入日常实践。将临终关怀模式和疼痛及症状管理原则推广到其他环境和专业护理领域，可能会减少广泛的疼痛差异。
