住院癌症患者疼痛管理结局现状及影响因素分析

Descriptive study of outcomes of cancer pain management in patients from good pain management ward

目的:探讨无痛病房住院癌症患者疼痛管理结局现状及影响因素。方法:应用美国疼痛协会患者结局问卷修订版,采用分层随机整群的抽样方法进行抽样后,对郑州市5家无痛病房458例癌症患者进行调查。结果:住院癌症患者平均疼痛程度得分为(3.16±1.39)分,疼痛对患者的影响程度得分为(3.68±1.94)分,患者疼痛管理满意度得分为(4.54±0.66)分,患者的疼痛信念得分为(2.45±0.88)分。回归分析结果显示,影响疼痛程度的因素有疼痛缓解程度、性别、等待止痛药时间、肿瘤分期、止痛药物类型、评估记录、疼痛治疗指数(P<0.05);影响疼痛对患者的影响程度的因素有换用其他止痛药物、疼痛缓解程度、等待止痛药时间、止痛药物类型、评估记录、用药方法(P<0.05);影响疼痛管理满意度的因素有疼痛缓解程度、护士态度、换用其他止痛药物、医院级别和疼痛治疗指数(P<0.05);影响疼痛信念的因素有护士关注度、医生态度、等待止痛药时间、疼痛缓解程度和医院级别(P<0.05)。结论:无痛病房癌症患者仍有中到低度的疼痛,疼痛信念较差。医护人员应对患者加强疼痛教育。

Aim： To describe the outcomes of cancer pain management in good pain management ward and explore related factors. Methods： The American Pain Society Patient Outcomes Questionnaire Modified was used to survey 458 cancer inpatients recruited from good pain management wards of five hospitals in Zhengzhou City. Results： The mean of the pain intensity was（ 3. 16 ± 1. 39）,the mean of pain interfere was（ 3. 68 ± 1. 94）,the mean of patients＇ satisfaction was（ 4. 54 ± 0. 66）,and the mean of pain beliefs was（ 2. 45 ± 0. 88）. The predictors of the pain intensity included pain relief,gender,waiting time for analgesic,cancer stage,analgesic type,assessment and recording,and pain treatment index（ P〈0. 05）. The predictors of the pain interfere included replacing for another analgesic,pain relief,waiting time for analgesic,analgesic type,assessment and recording,treatment method（ P〈0. 05）. The predictors of the pain management satisfaction included pain relief,nurses＇ attitude,replacing for changing analgesic,hospital level and pain treatment index（ P〈0. 05）. The predictors of the pain beliefs included doctors＇ and nurses＇ attention on pain,waiting time for analgesic,pain relief and hospital level（ P〈0. 05）. Conclusion： The score of pain intensity is in lower level,and the pain faith is poor.Medical personnel should strengthen pain education of cancer patients.