Liu Bing, Ding Yongyong, Xu Junfei, Wu Xuehai, Yang Xiaofeng, Liu Yi, Deng Hong
Department of Pain, The First People's Hospital of Zunyi City, Zunyi, Guizhou, 563000, People's Republic of China.
Cancer Manag Res. 2025 Sep 2;17:1871-1880. doi: 10.2147/CMAR.S537477. eCollection 2025.
To evaluate the effects of a comprehensive intervention program on cancer pain and self-efficacy in patients with lung cancer.
A total of 120 lung cancer patients with cancer pain who received treatment from January 2021 to December 2023 at The First People's Hospital of Zunyi were enrolled in this study. A within-subject design was used, comparing patients' pain and self-efficacy scores before and after a comprehensive intervention. The intervention included pharmacologic therapy, psychological counseling, health education, mindfulness training, social support, and personalized rehabilitation. Pain was assessed using the Numerical Rating Scale (NRS), and self-efficacy was measured with the Chronic Disease Self-Efficacy Scale (CDSE). Subgroup and regression analyses were performed to explore related factors.
After intervention, the average NRS pain score decreased significantly from 7.2 ± 1.5 to 3.8 ± 1.2 (↓47.22%, t=15.6, p<0.001). Patients participating in mindfulness training reported a greater reduction in pain than non-participants (p=0.013). The total CDSE score increased from 52.3 ± 8.7 to 72.4 ± 9.5 (t=12.4, p<0.001), with significant improvements across all subscales (self-management, general efficacy, goal achievement, and problem-solving; all p<0.001). Subgroup analyses revealed that the improvements were consistent across gender, age groups, and education levels (p>0.05). Logistic regression identified pain relief (NRS score) as a significant predictor of enhanced self-efficacy (OR=1.403, 95% CI: 1.125-1.885, p=0.002), whereas age and education were not significant.
A comprehensive, multimodal intervention significantly improved both pain control and self-efficacy in patients with lung cancer-related pain. The effects were robust across demographic subgroups, with pain relief being a key factor influencing self-efficacy. These findings support the integration of psychological and behavioral strategies in pain management for cancer patients.
评估一项综合干预方案对肺癌患者癌痛及自我效能的影响。
选取2021年1月至2023年12月在遵义市第一人民医院接受治疗的120例伴有癌痛的肺癌患者纳入本研究。采用自身前后对照设计，比较患者在综合干预前后的疼痛及自我效能评分。干预措施包括药物治疗、心理咨询、健康教育、正念训练、社会支持及个性化康复。采用数字评分量表（NRS）评估疼痛，用慢性病自我效能量表（CDSE）测量自我效能。进行亚组分析和回归分析以探索相关因素。
干预后，NRS疼痛平均评分从7.2±1.5显著降至3.8±1.2（下降47.22%，t=15.6，p<0.001）。参与正念训练的患者疼痛减轻程度大于未参与者（p=0.013）。CDSE总分从52.3±8.7增至72.4±9.5（t=12.4，p<0.001），所有子量表（自我管理、总体效能、目标达成及问题解决；均p<0.001）均有显著改善。亚组分析显示，不同性别、年龄组及教育水平的改善情况一致（p>0.05）。逻辑回归分析确定疼痛缓解（NRS评分）是自我效能增强的显著预测因素（OR=1.403，95%CI：1.125 - 1.885，p=0.002），而年龄和教育程度则无显著影响。
一项全面的多模式干预显著改善了肺癌相关疼痛患者的疼痛控制及自我效能。这些效果在不同人口统计学亚组中均很显著，疼痛缓解是影响自我效能的关键因素。这些发现支持在癌症患者疼痛管理中整合心理和行为策略。
