O'Brien Jack, Francis Anita
Fred Hutchinson Cancer Research Center, 1124 Columbia, Seattle, WA 98104 U.S.A.
Pain. 1988 Nov;35(2):171-178. doi: 10.1016/0304-3959(88)90224-2.
The clinical management of pain could be improved if more were known about the intensity and duration of the pain. The cancer patient, however, is often unable to communicate this information to caregivers. Relying on next-of-kin to provide information about the patient's pain could help, but little has been done to verify next-of-kin responses with respect to subjective experiences. For the present study 42 pairs of cancer patients and their next-of-kin were independently surveyed in 1982 in Washington state regarding their cancer pain and various aspects of medical treatment to determine whether proxies can give reliable responses. Close agreement between subject and next-of-kin was observed for the items which were salient and had a limited choice of responses, such as the presence of pain. Agreement in the aggregate was achieved for the items having several possible responses, such as the intensity and frequency of pain. Correspondence was virtually random for those items which had a variety of listed responses. The use of proxies in obtaining information, future research directions, and difficulties with measuring agreement are discussed.
如果能更多地了解疼痛的强度和持续时间，疼痛的临床管理就能得到改善。然而，癌症患者往往无法将这些信息传达给护理人员。依靠亲属提供有关患者疼痛的信息可能会有所帮助，但在核实亲属关于主观体验的回答方面几乎没有做什么工作。在1982年，针对42对癌症患者及其亲属在华盛顿州就他们的癌症疼痛和医疗治疗的各个方面进行了独立调查，以确定代理人是否能给出可靠的回答。对于那些突出且回答选择有限的项目，如疼痛的存在，观察到患者与亲属之间有密切的一致性。对于那些有几种可能回答的项目，如疼痛的强度和频率，总体上达成了一致。对于那些列出了各种回答的项目，一致性实际上是随机的。文中讨论了使用代理人获取信息的情况、未来的研究方向以及衡量一致性方面的困难。
