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65岁及以上女性乳腺癌幸存者的终身疼痛管理经历

Lifetime Pain Management Experiences of Female Breast Cancer Survivors Aged 65+ Years.

作者信息

Alsbrook Karen E, Wesmiller Susan W, Diego Emilia J, Scott Paul W, Harpel Caroline K, Keelan Erin V, Patzak Sofie A, Zhang Yuchen U, Thomas Teresa Hagan

机构信息

Department of Nursing, MD Anderson Cancer Center, Houston, TX.

Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA.

出版信息

Pain Manag Nurs. 2025 Feb;26(1):e97-e106. doi: 10.1016/j.pmn.2024.08.004. Epub 2024 Sep 5.

Abstract

PURPOSE

Explore factors influencing pain management among female breast cancer survivors aged 65+ years with moderate to severe pain based on a score of 4 or greater on the 0-10 numeric rating scale.

DESIGN

Qualitative descriptive study.

METHODS

We interviewed 21 purposefully sampled women aged 65+ years who experienced moderate to severe pain. Researchers coded interview transcripts for factors affecting study participants' pain management experiences.

RESULTS

Pain management facilitators included patient-centered interactions with care teams and reliance on psychosocial assets. Challenges included ineffective care team interactions and participants' negative perceptions of opioid analgesia. Other factors included pain attributed to cancer treatment, pain management plan adherence, and psychosocial influencers.

CONCLUSIONS

With regard to this sample, patient-centered communication and pain management education help female breast cancer survivors aged 65+ years manage their pain. Mitigation of opioid stigma and undermanaged painful comorbid conditions could further optimize pain management. Further research on the effects of breast cancer treatment, level of adherence to pain management recommendations, and psychosocial influences on pain management is needed.

CLINICAL IMPLICATIONS

Providing contact information for care team members during and after clinic hours facilitates open communication, including timely reporting of new and undertreated pain. Collaborating with the patient and care team on a clear pain management plan and establishing parameters for when to notify the care team empower patients to optimize management of their pain. Verifying patients' understanding of prescribed analgesia and management of side effects and providing education as needed may reduce negative perceptions of opioid analgesia.

摘要

目的

基于0 - 10数字评分量表得分为4分或更高,探究影响65岁及以上中度至重度疼痛的女性乳腺癌幸存者疼痛管理的因素。

设计

定性描述性研究。

方法

我们对21名经过有目的抽样的65岁及以上经历中度至重度疼痛的女性进行了访谈。研究人员对访谈记录进行编码,以找出影响研究参与者疼痛管理经历的因素。

结果

疼痛管理的促进因素包括与护理团队以患者为中心的互动以及对心理社会资源的依赖。挑战包括护理团队互动无效以及参与者对阿片类镇痛药物的负面看法。其他因素包括癌症治疗引起的疼痛、疼痛管理计划的依从性以及心理社会影响因素。

结论

就该样本而言,以患者为中心的沟通和疼痛管理教育有助于65岁及以上的女性乳腺癌幸存者管理疼痛。减轻阿片类药物污名化以及未得到充分管理的疼痛性合并症,可能会进一步优化疼痛管理。需要对乳腺癌治疗的影响、对疼痛管理建议的依从程度以及心理社会因素对疼痛管理的影响进行进一步研究。

临床意义

在门诊时间及之后提供护理团队成员的联系信息,有助于进行开放沟通,包括及时报告新出现的和未得到充分治疗的疼痛。与患者和护理团队共同制定明确的疼痛管理计划,并确定何时通知护理团队的参数,可使患者能够优化疼痛管理。核实患者对处方镇痛药的理解以及副作用的管理,并根据需要提供教育,可能会减少对阿片类镇痛药物的负面看法。

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