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中国多中心横断面研究:癌症患者与家庭照护者疼痛体验的一致性及其相关因素。

Congruence of cancer pain experience between patients and family caregivers and associated factors: a multicenter cross-sectional study in China.

机构信息

Nursing Administrative Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, NO. 52 Fucheng Road, Haidian district, Beijing, 100142, China.

出版信息

Support Care Cancer. 2021 Oct;29(10):5983-5990. doi: 10.1007/s00520-021-06156-2. Epub 2021 Mar 26.

Abstract

PURPOSE

The purposes of this study were to determine whether there were differences in the cancer pain experience between patients and family caregivers (FCGs) and to explore the associated factors that influence cancer pain experience congruence.

METHODS

A multicenter cross-sectional study was conducted. A total of 410 patient-family caregiver dyads completed face-to-face surveys, including information about basic characteristics, the Patient Pain Questionnaire (PPQ), and the Family Pain Questionnaire (FPQ). The difference in cancer pain experience between patients and family caregivers was analyzed using a paired t test. Indicators for the congruence of cancer pain experience were analyzed using the chi-square test and two independent-sample t tests for bivariate analysis and multivariate binary logistic regression analysis.

RESULTS

Of the patients, 57.1% were men, and 60.7% perceived moderate performance status. The majority of the family caregivers was female (54.9%). The mean (SD) score on the pain experience subscale was 4.82 (1.66) for 410 patients and 5.02 (1.66) for 410 family caregivers. The difference was significant (P < 0.01). Additionally, 87 (21.2%) dyads were in the congruent group, and 323 (78.8%) dyads were in the incongruent group. Patients' self-perceived moderate performance status (OR = 2.983, P < 0.01) and family caregivers' pain knowledge (OR = 1.171, P < 0.05) were the main factors influencing the congruence of cancer pain experience.

CONCLUSION

The findings of this study indicate that family caregivers reported significantly worse cancer pain experiences than patients. Family caregivers' pain knowledge was a primary influencing factor. It is suggested that educational interventions aimed at teaching family caregivers and patients how to communicate their pain experience and improving the knowledge of family members regarding pain and its management may help in aligning their perceptions and thereby contribute to better quality of life and pain management outcomes.

摘要

目的

本研究旨在确定患者和家属照顾者(FCG)之间的癌症疼痛体验是否存在差异,并探讨影响癌症疼痛体验一致性的相关因素。

方法

本研究采用多中心横断面研究。共纳入 410 对患者-家属照顾者,通过面对面问卷调查收集患者基本特征、患者疼痛问卷(PPQ)和家属疼痛问卷(FPQ)。采用配对 t 检验比较患者和家属照顾者癌症疼痛体验的差异,采用卡方检验和两独立样本 t 检验进行单因素分析,采用多因素二项逻辑回归分析进行多因素分析。

结果

410 例患者中,男性占 57.1%,60.7%的患者自评功能状态为中度。410 例家属照顾者中,女性占 54.9%。410 例患者疼痛体验子量表得分为 4.82(1.66),410 例家属照顾者得分为 5.02(1.66),差异有统计学意义(P<0.01)。87(21.2%)对患者和家属照顾者疼痛体验一致,323(78.8%)对患者和家属照顾者疼痛体验不一致。患者自评功能状态为中度(OR=2.983,P<0.01)和家属照顾者的疼痛知识(OR=1.171,P<0.05)是影响癌症疼痛体验一致性的主要因素。

结论

本研究结果表明,家属照顾者报告的癌症疼痛体验较患者更差。家属照顾者的疼痛知识是主要影响因素。建议对家属照顾者和患者进行教育干预,教授其如何沟通疼痛体验,并提高家属对疼痛及其管理的认识,以帮助他们调整对疼痛的认知,从而改善生活质量和疼痛管理效果。

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