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黑人癌症患者使用长效阿片类药物的疼痛体验的定性研究。

A Qualitative Study of the Pain Experience of Black Individuals With Cancer Taking Long-Acting Opioids.

机构信息

Author Affiliations: Nell Hodgson Woodruff School of Nursing (Drs Bruner, Yeager, and H. Lee and Ms S. Lee); Winship Cancer Institute (Drs Bruner and Yeager); Office of the Senior Vice President for Research (Dr Bruner), Emory University, Atlanta, Georgia; Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center (Dr Rosa), New York, New York; School of Nursing (Dr Belcher); Palliative Research Center (Dr Belcher), University of Pittsburgh; Hillman Cancer Center, University of Pittsburgh Medical Center (Dr Belcher), Pennsylvania; and Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania (Dr Meghani), Philadelphia.

出版信息

Cancer Nurs. 2024;47(2):E73-E83. doi: 10.1097/NCC.0000000000001197. Epub 2023 Feb 3.

Abstract

BACKGROUND

Little is known about the experience of Black individuals with cancer taking long-acting opioids for cancer pain.

OBJECTIVE

This study aimed to describe the day-to-day experience of living with pain and the experiences of taking opioids for pain management among Black individuals with cancer prescribed with long-acting opioids.

METHODS

This qualitative descriptive study was part of a larger investigation focused on opioid adherence. Participants (N = 14) were interviewed using a semistructured interview guide. Analysis followed conventional content analysis and constant comparison approaches. Sociodemographics, clinical information, and the Brief Pain Inventory form were collected.

RESULTS

The majority of the subsample was female (64.3%), not married (78.6%), and with a median age of 52.5 years. Participants were taking either MS Contin (85.7%) or OxyContin (14.3%). The Brief Pain Inventory median "average" pain severity scores and pain interference scores were 5.1/10 (interquartile range [IQR] = 6.1) and 3.5/10 (IQR = 6.7), respectively. Three themes are reported from the analyses: desire for control, barriers to pain relief, and isolation versus connectedness.

CONCLUSION

Our findings highlight the persistent nature of moderate to severe cancer pain and how pain and its treatment interfere with patients' lives. The findings describe ways that patients learn to manage and exert control over pain despite conflicting attitudes and dealing with opioid stigma.

IMPLICATION FOR PRACTICE

Clinicians should partner with patients with cancer, especially people of color, who may experience intersecting stigmas related to their cancer pain and opioid use, to best provide an individualized and culturally sensitive pain treatment plan.

摘要

背景

对于患有癌症并使用长效阿片类药物治疗癌痛的黑人个体,他们的体验鲜为人知。

目的

本研究旨在描述患有癌症并开具长效阿片类药物的黑人个体在日常生活中与疼痛作斗争的体验,以及他们在管理疼痛时使用阿片类药物的体验。

方法

这是一项定性描述性研究,是一项侧重于阿片类药物依从性的更大研究的一部分。参与者(N=14)使用半结构化访谈指南进行访谈。分析遵循常规内容分析和恒定性比较方法。收集社会人口统计学、临床信息和简明疼痛量表表格。

结果

该亚组的大多数参与者为女性(64.3%)、未婚(78.6%),年龄中位数为 52.5 岁。参与者服用的药物分别为美施康定(85.7%)或奥施康定(14.3%)。简明疼痛量表的“平均”疼痛严重程度评分和疼痛干扰评分中位数分别为 5.1/10(四分位距[IQR] = 6.1)和 3.5/10(IQR = 6.7)。分析报告了三个主题:对控制的渴望、缓解疼痛的障碍以及孤立与联系。

结论

我们的研究结果强调了中度至重度癌症疼痛的持续性质,以及疼痛及其治疗如何干扰患者的生活。研究结果描述了患者如何学会管理和控制疼痛,尽管存在矛盾的态度和处理阿片类药物污名化的问题。

实践意义

临床医生应该与癌症患者,尤其是有色人种患者合作,因为他们可能同时面临与癌症疼痛和阿片类药物使用相关的交叉污名,以最好地提供个体化和文化敏感的疼痛治疗计划。

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