综合医院门诊化疗患者生活质量与疼痛相关性分析

Quality of Life among Patients Receiving Chemotherapy in the Outpatient Departments of A General Hospital and Its Correlation with Pain

目的分析综合医院门诊化疗患者中疼痛发生的情况对社会功能和躯体症状的影响。方法采用问卷调查的方式对北京协和医院门诊化疗患者的一般情况、疼痛、睡眠、呕吐、便秘、社会功能状况等进行调查,并分析疼痛与它们的关系。结果门诊化疗患者中中重度疼痛发生率为12.2%,其中78.8%为持续性疼痛。疼痛的发生与肿瘤是否发生转移显著相关(P=0.000),疼痛强度和疼痛部位与疾病种类均显著相关(P=0.035,P=0.000)。15.7%(67/428)的患者在安静情况下就疼痛,24.5%的患者表示与家人说话会减轻疼痛,17.3%(74/428)的患者由于疼痛导致活动受限以及社会关系的改变,7%(30/428)的患者有食欲减退、情绪不稳。患者社会功能受损与睡眠、大便异常、困倦、疼痛强度均显著相关(P<0.05),睡眠异常与疼痛强度显著相关(P=0.000),排便异常与止痛药的使用无相关性(P=0.798)。结论门诊化疗患者中重度疼痛发生率较高,而且其社会功能下降与疼痛相关的躯体症状出现有关。

Objective To analyze the relationship of quality of life and pain in patients receiving chemotherapy in the outpatient departments in a general hospital.Method A questionnaire-based survey was conducted to collect data on pain status,sleep disorder,vomiting,constipation as well as the social function status.Results Among the 428 patient-times of survery,12.2% of the patients had moderate to severe pain,of which 78.8% was consistent pain.The occurrence of pain was closely related to the metastasis of cancer(P = 0.000).The intensity and location of pain were independently correlated to the origin of cancer(P = 0.035,P = 0.000).Nearly a quarter of patients(24.5%)agreed that talking with his/her family was helpful to relieve pain,while 17.3% of patients had ambulatory restriction or changes in social function.The changes in social function were closely related with sleeping disorder,constipation,fatigue,and intensity of pain(all P < 0.05).Furthermore,sleeping disorder was related to pain intensity(P = 0.000),while constipation had no relationship with analgesic medicines(P = 0.798).Conclusions A significantly large proportion of patients who are receiving chemotherapies in the outpatient departments of general hospital are suffering from moderate to severe pain.Their decreased social functions correlate with the cancer-related somatic symptoms.