Mao Peiyang, Tian Xin, Zhan Yinxia, Gao Feng, Tan Xiangyu, Yu Hongfan, Du Xiaobo, Li Jie, Feng Gang, Zhang Jingyu, Shi Qiuling
School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.
Department of Oncology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, People's Republic of China.
Cancer Manag Res. 2025 Aug 30;17:1843-1850. doi: 10.2147/CMAR.S532474. eCollection 2025.
Pain is common among patients with malignant tumors. It significantly impacts quality of life, yet over 80% of advanced cancer patients lack adequate pain management. Despite improvements in China's pain management program, challenges remain, especially for older adults and outpatient care.
We evaluated pain intensity management adequacy using a 0-10 numerical rating scale (NRS), and Pain Management Index (PMI) at an outpatient oncology clinic. Differences and changes in pain levels were statistically analyzed using -test, rank-sum, and chi-square tests. Factors associated with inadequate pain management were identified using multivariate logistic regression.
Among 589 participants, 45.41% scored moderate to severe pain ≥ 4, and 81.32% experienced inadequate pain management (PMI < 0). Pain was more severe among older, than younger patients (4.15 ± 2.89 vs 3.65 ± 2.41, < 0.001) and pain management was inadequate in older compared with younger patients (75.47% vs 89.87%). Undergoing targeted or immune adjuvant therapy (odds ratio [OR], 3.206; 95% confidence interval [CI], 1.538-6.684) and poor physical status (OR, 5.053; 95% CI, 2.023-12.622) emerged as significant risk factors for inadequate pain management.
Pain management is challenging for patients aged ≥60 years. Therefore, tailored interventions are needed to enhance care quality.
疼痛在恶性肿瘤患者中很常见。它对生活质量有显著影响，但超过80%的晚期癌症患者缺乏充分的疼痛管理。尽管中国的疼痛管理项目有所改善，但挑战依然存在，尤其是对老年人和门诊护理而言。
我们在一家门诊肿瘤诊所使用0至10的数字评分量表（NRS）和疼痛管理指数（PMI）评估疼痛强度管理的充分性。使用t检验、秩和检验和卡方检验对疼痛水平的差异和变化进行统计学分析。使用多因素逻辑回归确定与疼痛管理不充分相关的因素。
在589名参与者中，45.41%的人疼痛评分为中度至重度（≥4），81.32%的人疼痛管理不充分（PMI<0）。老年患者的疼痛比年轻患者更严重（4.15±2.89对3.65±2.41，P<0.001），与年轻患者相比，老年患者的疼痛管理不充分（75.47%对89.87%）。接受靶向或免疫辅助治疗（比值比[OR]，3.206；95%置信区间[CI]，1.538 - 6.684）和身体状况差（OR，5.053；95%CI，2.023 - 12.622）是疼痛管理不充分的重要危险因素。
对于60岁及以上的患者，疼痛管理具有挑战性。因此，需要采取针对性的干预措施来提高护理质量。
