McMillan S C
University of South Florida, College of Nursing, Tampa 33612, USA.
Cancer Nurs. 1996 Aug;19(4):298-307. doi: 10.1097/00002820-199608000-00006.
The purpose of this descriptive study was to explore the pain intensity and pain relief experienced by hospice patients with cancer and the variables that might be associated with that pain. The sample consisted of 118 consenting patients and their primary caregivers receiving hospice care in their homes. Methods involved a secondary analysis of data from a study of quality of life. The Hospice Quality of Life Index (HQLI), used in the study, assesses multidimensional aspects of quality of life including pain relief. Each item is assessed on a 1 (worst) to 10 (best) scale. To eliminate pain-free patients from the analysis, an additional item asks how severe pain is when it is at its worst. Both patients and caregivers were asked to evaluate the patient's quality of life on admission and after 3 weeks of hospice care. Relationships were sought among items on the HQLI and between pain and demographic characteristics. Results revealed that most patients experience pain (82%) but that caregivers were not able to accurately estimate that pain. Pain relief, even after 3 weeks of hospice care, was less than optimal, with many patients (42%) reporting pain relief at a level of 5 or less. A significant difference in pain at its worst was found by type of cancer. Although there were differences by gender, these were not significant. Pain was found to be weakly related to enjoyable activity, sleeping, fatigue, physical care, hope, and anger. Results support the idea that pain is important to overall quality of life, but despite its importance, pain in hospice patients with cancer still is not well managed.
这项描述性研究的目的是探究临终关怀的癌症患者所经历的疼痛强度和疼痛缓解情况，以及可能与该疼痛相关的变量。样本包括118名同意参与研究的患者及其主要照料者，他们均在家中接受临终关怀。研究方法包括对一项生活质量研究的数据进行二次分析。该研究中使用的临终关怀生活质量指数（HQLI）评估生活质量的多个维度，包括疼痛缓解情况。每个项目按1（最差）至10（最佳）的量表进行评估。为了在分析中排除无疼痛的患者，另外设置了一个项目询问疼痛最严重时的程度。患者和照料者均被要求在入院时和接受3周临终关怀护理后评估患者的生活质量。研究探寻了HQLI各项之间以及疼痛与人口统计学特征之间的关系。结果显示，大多数患者（82%）经历疼痛，但照料者无法准确估计该疼痛程度。即使经过3周的临终关怀护理，疼痛缓解情况仍未达到最佳，许多患者（42%）报告疼痛缓解程度为5或更低。按癌症类型发现疼痛最严重程度存在显著差异。虽然按性别也存在差异，但并不显著。研究发现疼痛与愉悦活动、睡眠、疲劳、身体护理、希望和愤怒之间存在弱相关性。结果支持了疼痛对总体生活质量很重要这一观点，但尽管其很重要，临终关怀的癌症患者的疼痛仍未得到很好的控制。
