恶性肿瘤患儿及其父母在疾病治疗过程中疼痛感知情况的调查研究

Pain perception in children with malignant tumor and their parents during disease treatment

目的探讨恶性肿瘤患儿及其父母在疾病治疗过程中对疼痛的感受和认知情况。方法采用方便抽样法,选取2017年6月—2019年2月入住首都医科大学附属北京儿童医院血液肿瘤中心日间病房的179例恶性肿瘤患儿及其179名父母为研究对象,分别采用自行编制的恶性肿瘤患儿疼痛调查问卷及恶性肿瘤患儿父母疼痛调查问卷对患儿及其父母进行调查。共发放问卷179份,回收有效问卷179份,有效回收率为100.0%。结果179名父母及179例患儿认为疾病治疗过程中疼痛发生率分别为100.0%(179/179)和98.3%(176/179),最严重时疼痛评分分别为(5.82±2.30)、(5.41±2.09)分,平均疼痛评分分别为(4.04±1.90)、(3.95±1.66)分;患儿及其父母在腰穿/鞘注、骨穿、PICC置管、留置针穿刺和静脉采血导致的疼痛感知方面比较差异均有统计学意义(P<0.05)。疼痛时对止痛剂使用有顾虑的父母和患儿分别为77.1%(138/179)和65.4%(117/179)。结论父母对于患儿疾病治疗过程中所经历的疼痛严重程度与患儿的感受具有较高的一致性。但父母认为在疾病治疗过程中难以忍受的治疗相关性疼痛高于患儿,在接受止痛剂态度方面较患儿被动。医护人员在进行疼痛评估时可以听取父母的意见,重视治疗相关性操作前对父母的宣教,采取措施降低甚至避免治疗相关性疼痛的发生,并加强止痛措施的培训。

Objective To explore the pain perception and cognition of children with malignant tumor and their parents during the disease treatment.Methods Using the convenient sampling method,a total of 179 children with malignant tumors and their 179 parents who were admitted to the day ward of Hematology and Oncology Center of Beijing Children's Hospital,Capital Medical University from June 2017 to February 2019 were selected as the research objects.The children and their parents were surveyed by using the self-developed Pain Questionnaire for Children with Malignant Tumor and the Pain Questionnaire for Parents of Children with Malignant Tumor.A total of 179 questionnaires were distributed,179 valid questionnaires were recovered,and the effective recovery rate was 100.0%.Results The incidence of pain during treatment in 179 parents and 179 children was 100.0%(179/179)and 98.3%(176/179),respectively.The average scores of 179 parents and 179 children who considered the most severe pain during disease treatment were respectively(5.82±2.30)and(5.41±2.09),and the average pain scores were(4.04±1.90)and(3.95±1.66),respectively.There were statistically significant differences in pain perception between children and their parents during lumbar puncture/thecal injection,bone puncture,PICC catheter placement,indwelling needle puncture and venous blood collection(P<0.05).A total of 77.1%(138/179)of parents and 65.4%(117/179)of children had concerns about the use of analgesics,respectively.Conclusions There is a high consistency between the severity of pain experienced by parents and the children's feelings during treatment.However,the parents feel that the unbearable treatment-related pain during the treatment of the disease is higher than that of children,and they are more passive than children in the attitude of receiving analgesics.Medical staff can listen to their parents'opinions during pain assessment,pay attention to education of parents before treatment-related operations,take measures to reduce or even avoid the occurrence of treatment-related pain and strengthen the training of pain relief measures.