Middle East Cancer Consortium, Haifa, Israel.
Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines.
J Palliat Med. 2022 Aug;25(8):1243-1248. doi: 10.1089/jpm.2021.0596. Epub 2022 Apr 18.
Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries. To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs. Descriptive survey. Fifty-six countries worldwide; convenience sample of 1639 consisted of 36.8% physicians; 45.1% nurses, and 4.5% pharmacists employed in varied settings. Improved pain management services are key elements. Top barriers include religion factors, lack of appropriate education and training at all levels, nonadherence to guidelines, patients' reluctance to report on pains, over regulation associated with prescribing and access to opioid analgesics, fear of addiction to opioids, and lack of discussions around prognosis and treatment planning. The majority of patients with cancer in low-income countries are undertreated for their pain. Promoting cancer pain accredited program of training and education on pain management for physicians and nurses is crucial, as well as advocating policymakers and the public at large.
预计未来十年全球癌症发病率将上升。尽管在诊断和治疗方面取得了进展，但在改善癌症疼痛治疗方面仍有许多工作要做，主要是在低收入国家服务不足的社区。 目的：确定高收入和低收入国家（根据世界卫生组织的分类）在疼痛管理方面的知识、信念和障碍；并了解改善现状的方法。 描述性调查。 在全球 56 个国家中，便利抽样的 1639 名参与者包括 36.8%的医生、45.1%的护士和 4.5%的药剂师，他们在不同的环境中工作。 改善疼痛管理服务是关键要素。主要障碍包括宗教因素、各级缺乏适当的教育和培训、不遵守指南、患者不愿报告疼痛、与开处方和获取阿片类镇痛药相关的过度监管、对阿片类药物成瘾的恐惧以及缺乏关于预后和治疗计划的讨论。 低收入国家的大多数癌症患者的疼痛治疗不足。为医生和护士推广癌症疼痛认证培训和教育计划至关重要，同时倡导政策制定者和广大公众。
