内蒙古自治区住院癌痛患者疼痛状况的调查

目的:调查内蒙古自治区肿瘤科住院的癌痛患者的疼痛状况,为本地区癌痛管理的实施提供依据。方法:通过对内蒙古自治区参加"春分行动调查"的5家三级甲等综合医院肿瘤科及1家肿瘤专科医院的患者进行问卷调查,并对53例存在癌痛的患者进行了疼痛情况以及镇痛情况的调查分析。调查内容包括:患者一般情况、疼痛部位性质、治疗前后疼痛评分变化、治疗方案、不良反应、患者满意度及治疗不满意患者和医护方面原因等。结果:本组癌痛患者入院时NRS(数字等级评分Numerical rating scale)评分为(6.15±2.37)分,轻度疼痛者9例(16.98%),中度疼痛者20例(22.64%),重度疼痛者24例(45.28%)。有49例(92.45%)患者应用止痛药治疗癌痛,其中46例(93.88%)应用口服止痛药,12例(9.48%)患者应用止痛药后疼痛完全缓解,疼痛控制理想42例(79.2%)。结论:内蒙古自治区住院癌症患者癌痛控制效果较满意,但在止痛药规范用药方面有待进一步加强。     

上海市医护人员癌痛认知状况调查及对策

目的调查上海市医护人员对癌痛管理的认知现状,为有效地实施癌痛管理提供依据。方法采用自行设计的医生、护士癌痛认知调查问卷对上海市三级甲等医院1000名医护人员进行调查。结果医护人员对癌痛管理的态度和行为较积极,认为自己能主动采取镇痛措施。但医护人员癌痛管理知识回答正确率不高,在某些方面医生回答的正确率明显高于护士(P<0.01)。55.8%的医生和44.9%的护士参加过癌痛管理的继续教育培训。结论上海市医护人员对癌痛管理知识了解不够深入,建议继续开展癌痛管理规范化培训,制定相关政策,以加强癌痛管理力度,提高癌症患者的生活质量。     

上海市医护人员癌痛管理态度和行为的调查研究

目的了解上海市医护人员癌痛管理的态度和行为,为癌痛管理方案与措施的制定和医护人员培训提供依据。方法采用自行设计的问卷对上海市三级甲等医院1000名医护人员进行癌痛管理态度和行为的调查。结果医护人员对癌痛管理的态度和行为较积极,90%以上医护人员认为有必要进行癌痛管理培训和癌痛控制,自己也能主动采取镇痛措施。在行为上,医生自评的疼痛管理行为明显较护士积极(P<0.01)。结论建议鼓励医护人员实施癌痛管理的积极性,继续加强癌痛管理的培训,促进癌痛管理规范化、正规化发展,改善癌痛管理的现状,提高患者的生活质量。     

十堰市三级甲等医院癌痛患者疼痛控制结局的现状调查及影响因素分析

目的了解十堰市三级甲等医院癌痛患者疼痛控制结局的现状,并分析其影响因素。方法 2016年8月至2017年8月,采用整群抽样的方法,选取十堰市开设有肿瘤科的3所三级甲等医院收治的303例癌痛患者作为研究对象,使用一般资料调查表、美国疼痛协会患者结局问卷修订量表(American Pain Society Patient Outcome Questionnaire Modified)对其进行问卷调查。结果本组患者疼痛控制结局的4个指标中,疼痛程度、疼痛对患者影响、疼痛信念的平均得分均低于国内常模水平,疼痛控制满意度得分高于国内常模水平(均P0.05)。多元线性回归分析结果显示,生活区域、文化程度为癌痛患者疼痛控制结局水平的影响因素,可解释总体变异的41.3%。结论十堰市三级甲等医院癌痛患者疼痛控制结局处于相对满意水平,护理管理者应根据患者不同的生活区域、文化程度加强对癌痛患者的规范化管理。     

癌痛控制障碍调查分析及护理对策

[目的]了解影响癌痛控制的因素,以便为有针对性的癌痛护理提供依据。[方法]采用自行设计的调查问卷对85名护士进行癌痛认知状况调查和对97例住院癌症病人进行癌痛认知、用药及疼痛控制情况调查。[结果]护士的癌痛相关知识贫乏,对癌痛治疗和评估存在错误认识,对病人健康宣教不足。癌痛病人缺乏对癌痛的认识,错误认为癌痛不可控制,担心止痛药成瘾和其他副反应,怕麻烦医护人员而强行忍痛,严重影响其生活质量。[结论]癌痛的有效控制有赖于医护人员、病人及家属三方的共同努力与合作,提高护理人员的癌痛认知水平对提高癌痛病人护理水平、帮助癌症病人有效控制疼痛、提高病人的生存质量具有重要的现实意义。     

癌痛控制障碍调查分析及护理对策

[目的]了解影响癌痛控制的因素,以便为有针对性的癌痛护理提供依据.[方法]采用自行设计的调查问卷对85名护士进行癌痛认知状况调查和对97例住院癌症病人进行癌痛认知、用药及疼痛控制情况调查.[结果]护士的癌痛相关知识贫乏,对癌痛治疗和评估存在错误认识,对病人健康宣教不足.癌痛病人缺乏对癌痛的认识,错误认为癌痛不可控制,担心止痛药成瘾和其他副反应,怕麻烦医护人员而强行忍痛,严重影响其生活质量.[结论]癌痛的有效控制有赖于医护人员、病人及家属三方的共同努力与合作,提高护理人员的癌痛认知水平对提高癌痛病人护理水平、帮助癌症病人有效控制疼痛、提高病人的生存质量具有重要的现实意义.     

307例住院癌痛患者疼痛控制满意度调查

目的了解住院癌痛患者疼痛控制情况、治疗现状以及患者的疼痛控制满意度。方法采用基本信息调查表和疼痛控制满意度调查表（Pain Treatment Satisfaction Scale,PTSS）对2010年8—11月在成都市某三级甲等医院住院接受止痛治疗的癌症患者进行问卷调查。结果癌痛患者在调查前1周内的疼痛评分（5.16±1.95）分,其治疗以单独使用口服药为主（152例）,疼痛控制满意率为72.3%,患者满意率最高的是用药途径（91.8%）和疼痛护理（90.8%）,最低的是健康教育相关信息（47.9%）。不同文化程度和用药途径患者疼痛控制满意度差异有统计学意义（P＜0.01）。结论住院癌痛患者疼痛控制以口服用药为主,控制满意率欠佳,应注重患者疼痛相关健康教育方式及内容,有效提高临床住院癌痛患者的疼痛控制满意度。     

癌痛的评估与护理措施

肿瘤镇痛治疗及护理是晚期肿瘤患者的重要问题。疼痛首先损害患者心理及精神状态，使其产生忧郁和恐惧心理，这种心理状态反过来可使疼痛加剧，形成恶性循环。有统计表明全世界每年新生癌症患者1000万，其中30％～50％伴有不同程度的疼痛，而我国约51％～61．1％的癌症患者伴有疼痛，如何减轻癌症患者的疼痛，提高患者的生活质量，是当前医务工作者共同关注的问题。     

癌痛的评估与护理措施

<正>肿瘤镇痛治疗及护理是晚期肿瘤患者的重要问题。疼痛首先损害患者心理及精神状态,使其产生忧郁和恐惧心理,这种心理状态反过来可使疼痛加剧,形成恶性循环。有统计表明全世界每年新生癌症患者1 000万,其中30%～50%伴有不同程度的疼痛,而我国约51%～61.1%的癌症患者伴有疼痛,如何减轻癌症患者的疼痛,提高患者的生活质量,是当前医务工作者共同关注的问题。     

癌痛控制影响因素的研究进展

文章综述了癌性疼痛控制障碍的影响因素,包括与患者、家属、医护人员及医疗体制和制度有关的因素,以期为癌痛的有效控制及致力于癌痛管理的医护人员提供有价值的理论参考。     

综合医院癌痛护理策略团队在老年癌痛管理中的实践

目的 探讨综合医院癌痛护理策略团队在老年癌症患者疼痛管理中的实践效果.方法 将92例老年癌痛患者随机分为两组各46例,常规组患者接受常规疼痛治疗和非团队护理人员护理,观察组患者接受常规疼痛治疗和癌痛护理策略团队实施的疼痛护理,评价干预2周后患者的疼痛强度、疼痛影响及生活质量.结果 干预2周后,两组患者疼痛强度、疼痛影响都有下降,整体生活质量得分上都有增加,但观察组效果优于常规组,差异均有统计学意义(P＜0.05).结论 癌痛护理策略团队的护理实践能有效降低老年癌痛患者的疼痛强度、疼痛影响,提高患者的生活质量.     

Pain Management: Association with Patient Satisfaction among Emergency Department Patients

Background

Patient satisfaction with emergency care is associated with timeliness of care, empathy, technical competence, and information delivery. Previous studies have demonstrated inconsistent findings regarding the association between pain management and patient satisfaction.

Objectives

This study was undertaken to determine the association between pain management and patient satisfaction among Emergency Department (ED) patients presenting with acute painful conditions.

Methods

In this survey study, a standardized interview was conducted at the Emergency Department at the University of Toledo Medical Center in May–July 2011. Participants were asked to answer 18 questions pertaining to patient satisfaction. Additional data collected included demographic information, pain scores, and clinical management.

Results

Among 328 eligible participants, 289 (88%) participated. The mean triage pain score on the verbal numeric rating scale was 8.2 and the mean discharge score was 6.0. The majority of patients (52%) experienced a reduction in pain of 2 or more points. Participants received one pain medication dose (44%), two medication doses (14%), three medication doses (5%), or four medication doses (2%). Reduction in pain scores of 2 or more points was associated with a higher number of medications administered. Reduction in pain scores was associated with higher satisfaction as scored on questions of patient perceptions of adequate assessment and response to pain, and treatment of pain.

Conclusions

There was a significant association between patient satisfaction and a reduction in pain of 2 or more points and number of medications administered. Effective pain management is associated with improved patient satisfaction among ED patients with painful conditions.     

Methadone as a First-Line Opioid in Cancer Pain Management: A Systematic Review

Aim

The objective of this review was to assess the existent evidence for the use of methadone as a first-line therapy in cancer pain management.

吗啡雾化吸入缓解肿瘤患者癌痛伴暴发性疼痛的效果

目的探讨吗啡雾化吸入缓解肿瘤患者癌痛伴暴发性疼痛(breakthrough pain,BTP;简称暴发痛)的起效时间及效果。方法便利抽样法选择2010年6月至2013年4月上海市第七人民医院肿瘤科收治的89例中重度癌痛患者,按入院先后将其分为观察组45例和对照组44例,两组患者分别采用一次性雾化吸入吗啡和口服即释吗啡缓解疼痛,比较两组患者暴发痛发作未给药剂时、药物起效时、下一次暴发痛发作时的疼痛评分(长海痛尺评定)及不良反应的发生情况。结果观察组患者用药后药物的起效时间为(5.29±0.756)min,短于对照组的(33.86±3.976)min,差异有统计学意义(P0.05);两种治疗方法均能有效缓解癌痛伴随的暴发痛;观察组有4例患者产生不良反应,对照组有16例,差异有统计学意义(P0.05)。结论雾化吸入吗啡具有起效快、效果佳、耐受好、不良反应少等特点,有利于改善肿瘤患者的生活质量。     

Breakthrough Cancer Pain in Patients With Abdominal Visceral Cancer Pain

Objective

The objective of this study was to assess the characteristics of breakthrough cancer pain (BTcP) in patients with abdominal cancer pain, and the eventual factors associated with its presentation.

The Verbal Numeric Pain Scale: Effects of Patient Education on Self-reports of Pain

Background: Emergency department (ED) patients are frequently asked to provide a self‐report of the level of pain experienced using a verbal numeric rating scale. Objectives: To determine the effects of patient education regarding the verbal numeric rating scale on self‐reports of pain among ED patients. Methods: In this prospective, interventional study, 310 eligible ED patients with pain, aged 18 years and older, were randomized to view either a novel educational video (n= 155) or a novel print brochure (n= 155) as an educational intervention, both developed to deliver educational information about the verbal numeric pain scale and its use. Participants initially rated their pain on a scale from 0 to 10 and then were administered the educational intervention. Following the educational intervention, participants completed a survey that included demographic information, postinterventional pain score, prior pain experience, and subjective rating of the helpfulness of the educational intervention. Fifty‐five consecutive participants were enrolled as controls and received no educational intervention but gave a self‐reported triage pain score and a second pain score at an equivalent time interval. Clinical significance was defined as a decrease in pain of 2 or more points following the education. Results: Following the educational interventions, there were statistically significant, although not clinically significant, decreases in mean pain scores within each intervention group (video: mean change, 1 point [95% confidence interval [CI] = 0.7 to 1.2]; printed brochure: mean change, 0.6 points [95% CI = 0.4 to 0.8]). For participants in the control group (no intervention), there was no significant change (mean change, 0.2 points [95% CI =?0.2 to 0.5]). A clinically significant decrease in pain was seen in 28% of the video group, 23% of the brochure group, and 5% of controls. Most patients had no change (71% of the video group, 73% of the brochure group, and 89% of controls). Participants rated the helpfulness of the video educational intervention as 7.1 (95% CI = 6.7 to 7.5) and the print educational intervention as 6.7 (95% CI = 6.2 to 7.1) on a scale from 0 (least effective) to 10 (most helpful). Conclusions: Among ED participants with pain, both educational interventions (video and printed brochure) resulted in statistically and clinically significant decreased self‐reported pain scores by 2 or more points in 26% of participants compared with 5% of controls. The educational interventions were rated as helpful by participants, with no appreciable difference between the two intervention groups.