J Hosp Palliat Nurs. 2023 Oct 1;25(5):E85-E93. doi: 10.1097/NJH.0000000000000965. Epub 2023 Jul 4.
Palliative care teams are increasingly called up to manage chronic pain in cancer survivors. Chronic pain is common in cancer survivors and is heavily influenced by biopsychosocial factors. This study aimed to determine the relative contribution of unique cancer-specific psychosocial factors, pain catastrophizing, and multisite pain to the pain experience in 41 cancer survivors who completed curative cancer treatment. To test the research hypotheses, a series of nested linear regression models were used with likelihood ratio testing to test the individual and collective contribution of cancer-specific psychosocial factors (fear of cancer recurrence, cancer distress, cancer-related trauma), pain catastrophizing, and the number of pain sites on the pain experience. The results indicate pain catastrophizing and multisite pain explained a significant degree of variance in pain interference scores ( P < .001) and pain severity ( P = .005). Cancer-specific psychosocial factors did not significantly predict variability in pain interference ( P = .313) or pain severity ( P = .668) over and above pain catastrophizing and the number of sites of pain. In summary, pain catastrophizing and multisite pain contribute to the chronic cancer-related pain experienced by cancer survivors. Palliative care nurses are well positioned to improve chronic pain among cancer survivors by assessing and treating pain catastrophizing and multisite pain.
姑息治疗团队越来越多地被要求管理癌症幸存者的慢性疼痛。慢性疼痛在癌症幸存者中很常见，并受到生物心理社会因素的严重影响。本研究旨在确定在 41 名完成根治性癌症治疗的癌症幸存者中，独特的癌症特定心理社会因素、疼痛灾难化和多部位疼痛对疼痛体验的相对贡献。为了检验研究假设，使用一系列嵌套线性回归模型，并使用似然比检验来检验癌症特定心理社会因素（对癌症复发的恐惧、癌症困扰、癌症相关创伤）、疼痛灾难化和疼痛部位数量对疼痛体验的个体和集体贡献。结果表明，疼痛灾难化和多部位疼痛解释了疼痛干扰评分（P<0.001）和疼痛严重程度（P=0.005）的显著差异。癌症特定的心理社会因素并不能显著预测疼痛干扰（P=0.313）或疼痛严重程度（P=0.668）的变化，超过了疼痛灾难化和疼痛部位的数量。总之，疼痛灾难化和多部位疼痛导致癌症幸存者慢性癌症相关疼痛。姑息治疗护士通过评估和治疗疼痛灾难化和多部位疼痛，为改善癌症幸存者的慢性疼痛做好了准备。
