Pinto Emilia, Gonçalves Ferraz, Sacarlal Jahit, Castro Luisa, Rego Guilhermina
School of Medicine, Porto University, Porto, Portugal; Pain Unit and Palliative Care Service, Maputo Central Hospital, Maputo, Mozambique.
School of Medicine, Porto University, Porto, Portugal; Palliative Care Service, Portuguese Oncology Institute, Porto, Portugal.
Ann Palliat Med. 2021 Apr;10(4):4069-4079. doi: 10.21037/apm-20-2009. Epub 2021 Apr 17.
Pain is the most feared and distressing symptom in palliative care. In advanced stages of cancer, its incidence is 70-80%. In Mozambique there is little published information concerning to the prevalence, intensity, and pain's management in cancer patients.
A cross-sectional observational study was conducted between August 2018 and January 2019, in Mozambique's main hospitals, and in the only hospital with an isolated provision of palliative care service. The analyzed data included demographic data, pain intensity and its treatment. The Pain Management Index was used to calculate the adequacy of the analgesia.
A total of 294 patients were included. The mean patients' age was 46.1 years old. Concerning to pain, 83.7% of the patients had pain, most of them moderate to severe pain. The prevalence of pain was frequent in women mainly in cervical cancer (84.3%) and in men with Kaposi sarcoma (80%). The main analgesic used for severe pain was paracetamol, and it was used alone in 40.9% of the patients. Morphine was used in 8.1% and adjuvants less than 10%. Pain Management Index was negative for 68.7% of the sample, meaning an inadequate analgesia. Significant differences were found in Pain Management Index levels between hospitals.
The prevalence of pain in the main health institutions in Mozambique is high. Paracetamol was the analgesic most used in severe pain. Further studies are needed to understand the main reasons of patients' suffering.
疼痛是姑息治疗中最令人恐惧和痛苦的症状。在癌症晚期，其发生率为70%-80%。在莫桑比克，关于癌症患者疼痛的患病率、强度及疼痛管理的公开信息很少。
2018年8月至2019年1月间，在莫桑比克的主要医院以及唯一一家单独提供姑息治疗服务的医院开展了一项横断面观察性研究。分析的数据包括人口统计学数据、疼痛强度及其治疗情况。采用疼痛管理指数来计算镇痛的充分性。
共纳入294例患者。患者的平均年龄为46.1岁。关于疼痛，83.7%的患者有疼痛，其中大多数为中度至重度疼痛。疼痛患病率在女性中较为常见，主要是宫颈癌患者（84.3%），在男性卡波西肉瘤患者中也较高（80%）。用于重度疼痛的主要镇痛药是对乙酰氨基酚，40.9%的患者单独使用该药。吗啡的使用比例为8.1%，辅助药物的使用比例不到10%。68.7%的样本疼痛管理指数为阴性，这意味着镇痛不足。不同医院之间的疼痛管理指数水平存在显著差异。
莫桑比克主要医疗机构中疼痛的患病率较高。对乙酰氨基酚是重度疼痛中最常用的镇痛药。需要进一步开展研究以了解患者痛苦的主要原因。
