癌症幸存者的慢性疼痛、功能及生活质量
Chronic pain, functionality and quality of life in cancer survivors.
作者信息
Poço Gonçalves João, Veiga Dalila, Araújo António
机构信息
Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
Department of Anaesthesiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
出版信息
Br J Pain. 2021 Nov;15(4):401-410. doi: 10.1177/2049463720972730. Epub 2020 Nov 30.
The increasing number of cancer survivors associated to a longer average life-span after diagnosis of an oncological disease facilitates the observation of deleterious long-term effects of both oncological disease and its treatment. Among these effects, chronic pain emerges as one of the most prevalent and, with its onset, there is a decrease in these patients' functionality and quality of life. The main focus in oncological disease treatment has been tumour eradication and average life expectancy extension after diagnosis, neglecting these deleterious long-term effects. This study aims at assessing the prevalence and characteristics of chronic pain in cancer survivors as well as pain interference in their quality of life and functionality. The study selected cancer survivors (n = 85) after dismissal from oncology service to assess the presence and characteristics of chronic pain, their health-related quality of life (HRQoL) and pain-related disability through a combination of different questionnaires. Chronic pain prevalence was 23.5%. In total, 85% of patients reported neuropathic pain descriptors and 45% presented diagnostic criteria for neuropathic pain. Of these patients, 45% were followed-up for pain surveillance and 35% underwent analgesic medication. There was a median pain disability index of 20.50 (14.50-35.00) and an average HRQoL of 0.5338 in chronic pain patients and 0.8872 in patients without pain. We found that chronic pain was the main negative predictor of HRQoL and was associated with decreased functionality. This study also concluded that these patients often were not offered the appropriate long-term medical follow-up. These findings highlight a need to raise awareness among health professionals to the importance of timely diagnosis and treatment of pain and its impact on HRQoL and functionality of long-term cancer survivors as well as the need to change clinical practice in order to improve healthcare provided to these patients.
肿瘤疾病诊断后癌症幸存者数量的增加以及平均寿命的延长，使得人们更容易观察到肿瘤疾病及其治疗带来的有害长期影响。在这些影响中，慢性疼痛是最普遍的问题之一，随着慢性疼痛的出现，这些患者的功能和生活质量会下降。肿瘤疾病治疗的主要重点一直是根除肿瘤以及延长诊断后的平均预期寿命，而忽略了这些有害的长期影响。本研究旨在评估癌症幸存者中慢性疼痛的患病率和特征，以及疼痛对其生活质量和功能的干扰。该研究选取了从肿瘤科室出院后的癌症幸存者（n = 85），通过综合不同问卷来评估慢性疼痛的存在和特征、他们的健康相关生活质量（HRQoL）以及疼痛相关残疾情况。慢性疼痛患病率为23.5%。总体而言，85%的患者报告有神经性疼痛描述符，45%的患者符合神经性疼痛的诊断标准。在这些患者中，45%接受了疼痛监测随访，35%接受了止痛药物治疗。慢性疼痛患者的疼痛残疾指数中位数为20.50（14.50 - 35.00），HRQoL平均分为0.5338，无疼痛患者的平均分为0.8872。我们发现慢性疼痛是HRQoL的主要负面预测因素，并且与功能下降有关。本研究还得出结论，这些患者往往没有得到适当的长期医学随访。这些发现凸显了提高健康专业人员对及时诊断和治疗疼痛的重要性以及疼痛对长期癌症幸存者的HRQoL和功能的影响的认识的必要性，同时也凸显了改变临床实践以改善为这些患者提供的医疗服务的必要性。
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