居家晚期癌症患者镇痛情况调查及镇痛满意度分析

Analysis of pain management and satisfaction on pain management of home-based advanced cancer patients with pain

目的调查晚期癌症居家患者的一般情况、癌性疼痛情况、镇痛情况及镇痛效果,分析影响晚期癌症患者镇痛效果的相关因素。方法对重庆医科大学附属第一医院宁养院2019年1月至2019年6月收治的138例初诊癌痛患者进行镇痛情况及镇痛满意度横断面研究,采用SPSS23.0软件进行统计学处理,描述性统计方法用于分析患者癌痛情况、镇痛药物使用情况和疼痛控制情况;Chi-square test用于癌痛治疗满意度影响因素分析。以P<0.05为差异有统计学意义。结果138例患者平均疼痛NRS得分7分,轻度疼痛5例(3.63%),中度疼痛61例(44.20%),重度疼痛72例(52.17%)。138例患者中109例既往接受过镇痛治疗,其中59例(54.13%)患者对镇痛治疗效果满意,50例(45.87%)患者不满意。恶性肿瘤临床分期和疼痛管理指数(pain management index,PMI)与镇痛满意度有相关性(P<0.05)。结论本研究发现癌痛患者的肿瘤临床分期及PMI与镇痛满意度相关,在临床实践中值得重视。虽然癌痛患者的阿片类药物使用比例上升,但仍有相当部分患者镇痛治疗不足,居家晚期癌痛患者的镇痛治疗应得到医护人员更多的关注。

Objective To detect the pain status and the pain management of home-based advanced cancer patients,and to investigate the key factors impacting the satisfaction on pain management.Methods Totally the data of 138 cases from the hospice department in the duration from Jan.2019 to Jun.2019 were collected and analyzed byχ2 test with SPSS 23.0.Results 109 cases in 138 cases received analgesics treatment before,54.13%of these participants expressed satisfaction with the effect of their pain management,and 45.87%showed unsatisfied on their pain management.Cancer clinical stage and PMI(pain management index)were both detected to be the significant factors for satisfaction of pain management(P<0.05,P=0.029;P<0.01,P=0.001).Conclusions Cancer clinical stage and PMI are found to be related to the satisfaction for pain management.The percentage of patients who use opioids increased.while there was still a part of patients suffering from inadequacy of pain management.The pain management for home-based advanced patients needs to be paid more attention by medical staff.