自我护理干预改善癌症疼痛的临床研究

Randomized clinical trial of self nursing intervention for improving cancer pain treatment

目的:评估护理干预对癌症疼痛患者疼痛强度、疼痛时间和镇痛药物使用的影响。方法:在疼痛门诊就诊的肿瘤伴骨转移患者90例,随机分为护理干预组47例和对照组43例。干预组护士在每周星期一、三、六对患者进行家访及护理干预,预防和管理与止痛剂相关的不良反应,指导患者在不能缓解疼痛时调整镇痛药剂量,适时与临床医师进行沟通。并且在星期二、四、五进行电话随访。对照组患者进行家访,监测患者服药的依从性,记录患者每天的疼痛时间、疼痛强度评分。结果:与干预前比较,护理干预组干预后第1周患者的疼痛强度评分和每天疼痛时间均显著减少(P<0.05),对照组患者疼痛强度评分和每天疼痛时间随干预时间延长而发生的变化差异无统计学意义(P>0.05)。护理干预后第2~6周,两组患者的疼痛强度评分和每天疼痛时间差异均有显著性(P<0.05)。两组患者使用镇痛药物类别随时间变化的差异无统计学意义(P>0.05)。结论:护理干预能改善患者疼痛强度和疼痛时间,值得推广应用。

Objective： To evaluate the effect of nursing intervention on pain intensity, time of pain and the use of analgesics for cancer patients with bone metastasis. Methods： Ninety oncology outpatients with bone metastasis cured in the pain clinic of Nanchong Central Hospital were randomized into two groups： nursing intervention group （n=47） and control （n=43） group. Patients in nursing intervention group got home visiting and nursing intervention on Monday, Wednesday and Saturday every week to help them to prevent and treat the side-effects of analgesics, adjust the dosage of analgesics when the pain was not relieved, make communication with and ask for help from the clinic physicians when necessary, and the patients were followed up through telephone on Tuesday, Thursday and Friday every week. Patients in control group received the same frequency of interview for inquiring analgesics intake. The lasting time and the intensity of daily pain were recorded. Results： The pain intensity scores decreased and the lasting time of pain shortened from the 1st week after nursing intervention in nursing intervention group （P〈0.05）. No significant difference was found of pain intensity scores and the lasting time of pain in control group before and after intervention （P〉0.05）. No significant difference existed in the change of analgesics category following the time between the two groups （P〉0.05）. Conclusions： Nursing intervention can reduce the pain intensity and shorten the lasting time of pain, so is worthy of popularization and application in treatment of cancer patients with bone metastasis.