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乳腺癌女性患者术后急性和亚急性疼痛:发生率及其与生物心理社会预测因素的关联——一项随机对照试验的二次分析

Acute and subacute postsurgical pain in women with breast cancer: incidence and associations with biopsychosocial predictors-a secondary analysis of a randomized controlled trial.

作者信息

Munk Alice, Jacobsen Henrik Børsting, Schnur Julie, Montgomery Guy, Reme Silje Endresen

机构信息

The Mind Body Lab, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.

Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.

出版信息

Pain Rep. 2023 Jan 10;8(1):e1058. doi: 10.1097/PR9.0000000000001058. eCollection 2023 Jan.

Abstract

INTRODUCTION

Women who undergo breast cancer surgery risk suffering from postsurgical pain long after their surgery. Still, research on postsurgical pain in the subacute phase has been neglected.

OBJECTIVE

This study aims to investigate the incidence, intensity, unpleasantness, and presurgical predictors of acute and subacute postsurgical pain after breast cancer surgery.

METHODS

The study used an observational design through secondary analyses of the control group in a randomized controlled trial. Data from 102 women undergoing breast cancer surgery were included. Levels of acute and subacute pain intensity and unpleasantness were measured using 100 mm Visual Analogue Scales on the day of surgery and 4 weeks postsurgery. Linear regression analyses were performed to identify presurgical biopsychosocial predictors of acute and subacute postsurgical pain.

RESULTS

Average levels of postsurgical pain intensity and unpleasantness were as follows: 22.7 mm for acute pain intensity, 19.0 mm for acute pain unpleasantness, 10.3 mm for subacute pain intensity, and 11.7 mm for subacute pain unpleasantness. Pain expectancy predicted acute pain intensity (R = 0.04, = 0.047) and acute unpleasantness (R = 0.06, = 0.02). Perceived social support inversely predicted acute pain unpleasantness (R = 0.04, = 0.014).

CONCLUSION

Mild and moderate acute pain intensity and unpleasantness are common after breast cancer surgery, whereas levels of subacute pain intensity and unpleasantness are low. Pain expectancy predicts acute postsurgical pain intensity and unpleasantness, whereas expected social support inversely predicts acute postsurgical pain unpleasantness.

摘要

引言

接受乳腺癌手术的女性在术后很长一段时间都有遭受术后疼痛的风险。然而,关于亚急性期术后疼痛的研究一直被忽视。

目的

本研究旨在调查乳腺癌手术后急性和亚急性术后疼痛的发生率、强度、不愉快程度以及术前预测因素。

方法

本研究采用观察性设计,通过对一项随机对照试验的对照组进行二次分析。纳入了102名接受乳腺癌手术的女性的数据。在手术当天和术后4周,使用100毫米视觉模拟量表测量急性和亚急性疼痛强度及不愉快程度。进行线性回归分析以确定急性和亚急性术后疼痛的术前生物心理社会预测因素。

结果

术后疼痛强度和不愉快程度的平均水平如下:急性疼痛强度为22.7毫米,急性疼痛不愉快程度为19.0毫米,亚急性疼痛强度为10.3毫米,亚急性疼痛不愉快程度为11.7毫米。疼痛预期预测急性疼痛强度(R = 0.04,P = 0.047)和急性不愉快程度(R = 0.06,P = 0.02)。感知到的社会支持反向预测急性疼痛不愉快程度(R = 0.04,P = 0.014)。

结论

乳腺癌手术后轻度和中度急性疼痛强度及不愉快程度较为常见,而亚急性疼痛强度和不愉快程度较低。疼痛预期预测急性术后疼痛强度和不愉快程度,而预期的社会支持反向预测急性术后疼痛不愉快程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2fe/9833448/8b749d92a37e/painreports-8-e1058-g001.jpg

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