Patel Terral, Fung Nicholas, Gardiner Lauren, Daniels Kelly E, Lu Nathan, Krause Rene, Wetter Julie, Viljoen Gerrit, Fagan Johannes J
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, United States of America.
Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town, Cape Town, South Africa.
J Coll Med S Afr. 2024 May 10;2(1):56. doi: 10.4102/jcmsa.v2i1.56. eCollection 2024.
Pain is often a significant symptom in patients with head and neck cancer (HNC). The objective of this study was to determine the prevalence of pain, factors limiting effective pain management, and whether differences in pain management exist between the public and private health sectors in South Africa in HNC patients after they have completed treatment.
A cross-sectional survey using the Brief Pain Inventory was performed on adults over the age of 18 years treated for HNC of any subsite in both a public and private hospital in Cape Town, South Africa.
Overall pain scores indicated mild levels of pain and impact on daily activities. The domains of life most affected by pain were general activity, sleep and mood. There was no difference in pain scores between public hospital patients versus those with private insurance. Less than half of the patients reported receiving all their necessary medications. Most of the postoperative pain was managed with paracetamol, tramadol and ibuprofen, with only 12.8% of patients using morphine.
This study provides a survey of pain experiences in HNC patients in a middle-income country. Insurance status did not significantly impact pain experiences, indicating equitable access to pain management resources. However, the overall utilisation of morphine and medications used to treat neuropathic pain is low. Further research is needed into the complex factors associated with pain in HNC patients.
This article is an example of a standard clinical study on patient-reported outcome measures.
疼痛通常是头颈癌（HNC）患者的一个重要症状。本研究的目的是确定疼痛的患病率、限制有效疼痛管理的因素，以及南非公立和私立医疗部门在HNC患者完成治疗后疼痛管理方面是否存在差异。
在南非开普敦的一家公立医院和一家私立医院，对18岁以上接受过任何亚部位HNC治疗的成年人进行了一项使用简明疼痛量表的横断面调查。
总体疼痛评分表明疼痛程度较轻且对日常活动有影响。受疼痛影响最大的生活领域是一般活动、睡眠和情绪。公立医院患者与有私人保险的患者在疼痛评分上没有差异。不到一半的患者报告说他们得到了所有必要的药物。大多数术后疼痛通过对乙酰氨基酚、曲马多和布洛芬进行管理，只有12.8%的患者使用吗啡。
本研究对一个中等收入国家HNC患者的疼痛经历进行了调查。保险状况对疼痛经历没有显著影响，表明在获取疼痛管理资源方面具有公平性。然而，吗啡和用于治疗神经性疼痛的药物的总体使用率较低。需要对与HNC患者疼痛相关的复杂因素进行进一步研究。
本文是一项关于患者报告结局指标的标准临床研究的范例。
