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肿瘤疾病长期幸存者的癌症相关疼痛:当前护理状况的调查结果

Cancer-related pain in long-term survivors of oncological diseases: results of a survey on the current care situation.

作者信息

Hofbauer H, Kieselbach K, Wirz S, Bundscherer A, Stamer U M, Rapp F

机构信息

Pain Therapy Unit, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89075, Ulm, Germany.

Interdisciplinary Pain Center, Medical Center University Freiburg, Breisacher Str. 117, 79016, Freiburg, Germany.

出版信息

Support Care Cancer. 2024 Dec 20;33(1):44. doi: 10.1007/s00520-024-09081-2.

Abstract

PURPOSE

The increasing survival rates of oncology patients have led to a corresponding increase in long-time survivors living with chronic cancer-related pain. Data is scarce on the care situation for this distinct clinical entity and on specific therapy requirements, such as interdisciplinary, multimodal pain therapy (IMPT). Our cross-sectional study aimed to assess the current care situation, distinct chronification factors, and optimization potential. This survey addresses this need in Germany, but also provides results with international implications.

METHODS

Via an online survey, German Pain Society members involved in the treatment of long-time survivors with chronic cancer-related pain assessed the current care situation, chronification factors, specific treatment needs, and the required practitioner's expertise. The German Pain Society's Cancer Pain Working Group created the non-validated questionnaire using the Delphi method.

RESULTS

One hundred fifty-nine Pain Society members across 70% of Germany's postal regions answered our survey. Respondents (primarily physicians, and 75% with + 6 years of experience) assessed the care situation as worse for chronic cancer-related pain compared to acute pain. Only 10% of the sites provided specific therapy for chronic cancer-related pain (mostly via outpatient treatment). Compared to non-cancer-related pain, additional, cancer-specific chronification factors were assumed, especially at psychological levels, and these need incorporating into therapies. A majority of practitioners recommended cancer-specific IMPT and specific pain expertise for this distinct clinical entity.

CONCLUSIONS

Members from the German Pain Society assume that there are relevant deficits in the care of long-term survivors with chronic cancer-related pain. The situation may be assessed differently by other groups, e.g., oncologists, and the data relates to Germany. Nevertheless, considering the raising survival rates, it can be supposed that there is reason to be concerned about an increasing care deficit. Thus, besides expanding the range of available treatment and raising awareness, IMPT with specially trained personnel should be developed to address the care needs of cancer survivors experiencing chronic cancer-related pain.

摘要

目的

肿瘤患者生存率的提高导致长期存活且伴有慢性癌症相关疼痛的患者相应增加。关于这一独特临床实体的护理情况以及具体治疗需求(如多学科、多模式疼痛治疗[IMPT])的数据稀缺。我们的横断面研究旨在评估当前的护理情况、不同的慢性化因素以及优化潜力。这项调查满足了德国的这一需求,但也提供了具有国际意义的结果。

方法

通过在线调查,参与治疗患有慢性癌症相关疼痛的长期存活者的德国疼痛学会成员评估了当前的护理情况、慢性化因素、具体治疗需求以及所需从业者的专业知识。德国疼痛学会癌症疼痛工作组采用德尔菲法创建了这份未经验证的问卷。

结果

德国70%邮政区域的159名疼痛学会成员回答了我们的调查。受访者(主要是医生,75%有6年以上经验)认为慢性癌症相关疼痛的护理情况比急性疼痛更差。只有10%的机构提供慢性癌症相关疼痛的特定治疗(主要通过门诊治疗)。与非癌症相关疼痛相比,人们认为存在额外的、特定于癌症的慢性化因素,尤其是在心理层面,这些因素需要纳入治疗中。大多数从业者建议针对这一独特临床实体进行特定于癌症的IMPT和特定的疼痛专业治疗。

结论

德国疼痛学会成员认为,在护理患有慢性癌症相关疼痛的长期存活者方面存在相关不足。其他群体(如肿瘤学家)可能会对这种情况有不同的评估,而且这些数据与德国有关。然而,考虑到生存率的提高,可以认为有理由担心护理不足的情况会增加。因此,除了扩大可用治疗范围和提高认识外,还应培养经过专门培训的人员进行IMPT,以满足患有慢性癌症相关疼痛的癌症幸存者的护理需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7653/11662055/325a6c0f54ac/520_2024_9081_Fig1_HTML.jpg

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