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放疗患者疼痛患病率、疼痛管理充分性及影响因素的评估

Assessment of the prevalence of pain, adequacy of pain management and influencing factors in patients undergoing radiotherapy.

作者信息

Jamora Kurl E, Castillo Michelle Regina L, Calaguas Miriam Joy C

机构信息

Division of Radiation Oncology, Department of Radiology, University of the Philippines-Philippine General Hospital, Taft Avenue, Ermita, Manila 1000, Philippines.

出版信息

Ecancermedicalscience. 2022 Dec 2;16:1483. doi: 10.3332/ecancer.2022.1483. eCollection 2022.

Abstract

Pain is prevalent among patients with cancer who are being treated with radiotherapy. However, the prevalence of pain varies across regions, and pain management is affected by several factors. This cross-sectional study aims to determine the prevalence of pain, assess the adequacy of pain management and identify factors affecting pain in patients undergoing radiotherapy. A total of 94 patients were included in the study. The prevalence of pain was determined through the Brief Pain Inventory tool, while the adequacy of pain management was assessed through the Pain Management Index. Demographic, clinical and treatment-related factors were obtained and analysed for association with the presence of pain and the adequacy of pain management. Of the 94 patients, 59 (62.8%) experienced pain while 35 (47.2%) did not. The mean pain intensity score of patients was 3.6 (standard deviation: 2.3). Most patients (67.8%) experienced mild pain with low pain interference (67.8%) on daily functions. Of the 59 patients who experienced pain, 34 (57.6%) had inadequate pain relief while 25 (42.2%) had adequate pain control. Being admitted at the hospital during radiotherapy was significantly associated with adequate pain relief. Use of analgesic was also significantly associated with pain management, with a higher rate of weak and strong opioid use in those with adequately treated pain. In this single-institution study, the prevalence of pain was high. Pain management was inadequate in more than half of the patients experiencing pain. A disparity in the prescription of analgesics, particularly opioids, was observed. Patients with inadequate pain management were less likely to receive opioids, which likely reflects the presence of several barriers that limit its access to patients.

摘要

疼痛在接受放射治疗的癌症患者中普遍存在。然而,疼痛的患病率因地区而异,且疼痛管理受到多种因素影响。这项横断面研究旨在确定疼痛的患病率,评估疼痛管理的充分性,并识别影响接受放射治疗患者疼痛的因素。共有94名患者纳入该研究。通过简明疼痛量表工具确定疼痛的患病率,同时通过疼痛管理指数评估疼痛管理的充分性。获取人口统计学、临床和治疗相关因素,并分析其与疼痛存在及疼痛管理充分性的关联。94名患者中,59名(62.8%)经历疼痛,35名(47.2%)未经历疼痛。患者的平均疼痛强度评分为3.6(标准差:2.3)。大多数患者(67.8%)经历轻度疼痛,对日常功能的疼痛干扰较低(67.8%)。在经历疼痛的59名患者中,34名(57.6%)疼痛缓解不足,25名(42.2%)疼痛得到充分控制。放疗期间住院与疼痛充分缓解显著相关。使用镇痛药也与疼痛管理显著相关,疼痛得到充分治疗的患者中使用弱阿片类和强阿片类药物的比例更高。在这项单机构研究中,疼痛患病率较高。超过一半经历疼痛的患者疼痛管理不足。观察到镇痛药处方存在差异,尤其是阿片类药物。疼痛管理不足的患者不太可能接受阿片类药物,这可能反映出存在多种限制患者获得阿片类药物的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc46/9934969/6ab2cbde4fa2/can-16-1483fig1.jpg

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