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医护人员对癌症疼痛管理中阿片类镇痛药的知识和障碍的调查。

A Survey of Knowledge and Barriers of Healthcare Professionals toward Opioid Analgesics in Cancer Pain Management.

机构信息

Department of Clinical Pharmacy Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.

Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan.

出版信息

Int J Clin Pract. 2022 Apr 12;2022:1136430. doi: 10.1155/2022/1136430. eCollection 2022.


DOI:10.1155/2022/1136430
PMID:35685510
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9159223/
Abstract

PURPOSE: Pain is among the most frequent and troubling symptoms in cancer patients. Despite the availability of updated treatment guidelines and effective pharmacological therapies, undertreatment of cancer pain remains a global problem. Opioids are the mainstay analgesics to treat moderate-to-severe cancer pain. The goal of this study was to assess the knowledge and barriers towards opioid analgesics for cancer pain management among healthcare professionals in Oncology Units in Jordan. METHODS: A structured questionnaire was administered to healthcare professionals (consultant doctors, resident doctors, pharmacists, and nurses) at three Oncology Units in a cross-sectional study design. RESULTS: A total of 201 healthcare professionals completed the questionnaire. The average age was 34.8 ± 8.1 years (range 23-58) and 49.3% of respondents were nurses. The mean score for the knowledge of opioids was 12.5 ± 3.2 out of 24 points (range 2-20). An acceptable level of knowledge was observed in 50.7% of participants, while 49.3% had poor knowledge. Knowledge items mostly answered incorrectly were related to opioid administration, pharmacology, dosing, adverse events, rotation, and toxicity. Knowledge scores were significantly higher for consultant doctors compared to pharmacists and nurses (=0.016 and < 0.001, respectively). Healthcare professionals who handled opioid analgesics had significantly higher mean knowledge scores than those who did not (=0.012). Linear regression analysis revealed that being a consultant physician has an independent, statistically significant association with higher knowledge scores. Among perceived barriers to using opioids, fear of addiction by patients was the most frequently reported barrier by respondents (79.6%). Other highly recognized barriers were fear of adverse effects by patients (67.2%) and lack of training programs on opioid dosing and monitoring (63.7%). CONCLUSIONS: This study revealed major gaps in the knowledge of opioids and pain management among healthcare professionals. There is an urgent need for developing innovative interventions to improve the knowledge of opioid analgesics and the understanding of pain management guidelines among healthcare professionals in Jordan.

摘要

目的:疼痛是癌症患者最常见和最困扰的症状之一。尽管有更新的治疗指南和有效的药物治疗方法,癌症疼痛的治疗不足仍然是一个全球性问题。阿片类药物是治疗中重度癌症疼痛的主要镇痛药。本研究的目的是评估约旦肿瘤学单位医护人员对癌症疼痛管理中阿片类镇痛药的知识和障碍。

方法:采用横断面研究设计,对三家肿瘤学单位的医护人员(顾问医生、住院医生、药剂师和护士)进行了结构化问卷。

结果:共有 201 名医护人员完成了问卷。平均年龄为 34.8±8.1 岁(范围 23-58 岁),49.3%的受访者为护士。阿片类药物知识平均得分为 24 分中的 12.5±3.2 分(范围 2-20 分)。观察到 50.7%的参与者具有可接受的知识水平,而 49.3%的参与者知识水平较差。回答错误较多的知识项目与阿片类药物的给药、药理学、剂量、不良反应、轮换和毒性有关。顾问医生的知识评分明显高于药剂师和护士(=0.016 和 < 0.001)。处理阿片类镇痛药的医护人员的平均知识评分明显高于未处理的医护人员(=0.012)。线性回归分析显示,顾问医生是与较高知识评分相关的独立、具有统计学意义的因素。在使用阿片类药物的障碍中,受访者最常报告的障碍是患者对成瘾的恐惧(79.6%)。其他高度认可的障碍是患者对不良反应的恐惧(67.2%)和缺乏阿片类药物剂量和监测的培训计划(63.7%)。

结论:本研究揭示了约旦医护人员在阿片类药物和疼痛管理知识方面存在重大差距。迫切需要制定创新干预措施,以提高约旦医护人员对阿片类镇痛药的知识和对疼痛管理指南的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eff/9159223/7563aa4d5b7d/IJCLP2022-1136430.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eff/9159223/7563aa4d5b7d/IJCLP2022-1136430.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eff/9159223/7563aa4d5b7d/IJCLP2022-1136430.001.jpg

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[5]
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[7]
The experience of patients with hematological malignancy in their terminal stage: a phenomenological study from Jordan's perspective.

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本文引用的文献

[1]
Practices and Hindrances in Cancer Pain Management: Results of a National Multi-Cancer Center Survey Among Healthcare Professionals in China.

Cancer Manag Res. 2021-2-18

[2]
Knowledge and attitudes regarding cancer pain management among oncology nurses in China.

J Int Med Res. 2021-1

[3]
Opioid prescribing attitudes of palliative care physicians versus other specialists: a questionnaire-based survey.

Postgrad Med J. 2022-2

[4]
Basic Opioid Pharmacology - An Update.

Br J Pain. 2020-5

[5]
A Cross-Sectional Web-Based Survey of Medical Practitioners in India to Assess their Knowledge, Attitude, Prescription Practices, and Barriers toward Opioid Analgesic Prescriptions.

Indian J Palliat Care. 2019

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J Crit Care. 2019-8-13

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J Natl Compr Canc Netw. 2019-8-1

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J Cancer Educ. 2020-4

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Semin Oncol Nurs. 2019-5-10

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Pain Manag Nurs. 2019-6

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