Yang Hong, Yu Wenhua, Zhang Hong, Heng Fanxiu, Ma Xiaoxiao, Li Na, Wang Zhanying, Hou Xiaoting, Guo Renxiu, Lu Yuhan
Nursing Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Asia Pac J Oncol Nurs. 2022 Jan 4;9(2):88-96. doi: 10.1016/j.apjon.2021.12.017. eCollection 2022 Feb.
The aim of this study was to evaluate the effects of whole process management model interventions based on information system benefits reported by patients with cancer pain.
We performed a quantitative, prospective nonrandomized controlled design from June to October 2020. A total of 124 cancer patients with pain were enrolled. Patients in the experimental group received a whole process management model intervention based on an information system compared to the control group who received routine cancer pain management. Data were collected at baseline and after a four-week follow-up, acting as a test-retest control. The primary outcome was pain management quality, which was measured using the American Pain Society Patient Outcome Questionnaire-Chinese version (APS-POQ-C). Secondary outcomes were patient-related attitudinal barriers and analgesic adherence. The Barrier Questionnaire (BQ) and a single-item questionnaire were used. Chi-square tests were used to compare the pain intensity and analgesic adherence, independent sample -test and Mann-Whitney U test were performed to test the differences in the pain management quality and patient-related attitudinal barriers between control and experimental groups.
Baseline characteristics and outcomes of the participants did not differ significantly ( > 0.05). Primary outcomes were changes in four aspect of the quality of pain management (APS-POQ-C) between the two groups ( < 0.05). Patients in the whole process management group reported significantly better pain control and perception of care than the control group. With respect to secondary endpoints, a significant difference in favor of the experimental group was found for barriers ( < 0.05) and medication adherence (60.0% vs. 40.0%; < 0.05) after the interventions.
The whole process management of patients with cancer pain effectively improves patient-reported quality of pain management, reduces patient-perceived barriers, enhances patient adherence to analgesic drugs and is worthy of clinical application.
本研究旨在评估基于信息系统的全过程管理模式干预对癌症疼痛患者报告的益处。
我们于20202020年6月至10月进行了一项定量、前瞻性非随机对照设计。共纳入124例癌症疼痛患者。与接受常规癌症疼痛管理的对照组相比，实验组患者接受基于信息系统的全过程管理模式干预。在基线和四周随访后收集数据，作为重测对照。主要结局是疼痛管理质量，使用美国疼痛协会患者结局问卷中文版（APS-POQ-C）进行测量。次要结局是患者相关的态度障碍和镇痛依从性。使用障碍问卷（BQ）和单项问卷。采用卡方检验比较疼痛强度和镇痛依从性，采用独立样本t检验和曼-惠特尼U检验来检验对照组和实验组在疼痛管理质量和患者相关态度障碍方面的差异。
参与者的基线特征和结局无显著差异（P>0.05）。主要结局是两组之间疼痛管理质量（APS-POQ-C）四个方面的变化（P<0.05）。全过程管理组的患者报告的疼痛控制和护理感知明显优于对照组。关于次要终点，干预后在障碍方面（P<0.05）和药物依从性方面（60.0%对40.0%；P<0.05）发现实验组有显著差异。
癌症疼痛患者的全过程管理有效提高了患者报告的疼痛管理质量，减少了患者感知的障碍，增强了患者对镇痛药的依从性，值得临床应用。
