Peiyang Mao, Xin Tian, Yinxia Zhan, Feng Gao, Xiangyu Tan, Hongfan Yu, Xiaobo Du, Jie Li, Gang Feng, Jingyu Zhang, Qiuling Shi
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引用次数: 0
摘要
背景：疼痛在恶性肿瘤患者中很常见。它显著影响生活质量，但超过80%的晚期癌症患者缺乏适当的疼痛管理。尽管中国的疼痛管理项目有所改善，但挑战依然存在，尤其是在老年人和门诊护理方面。方法：我们采用0-10数值评定量表（NRS）和疼痛管理指数（PMI）对一家肿瘤门诊进行疼痛强度管理充分性评估。采用t检验、秩和和卡方检验对疼痛程度的差异和变化进行统计学分析。使用多变量逻辑回归确定与疼痛管理不足相关的因素。结果：589名参与者中，45.41%的人疼痛评分为中至重度≥4分，81.32%的人疼痛管理不足（PMI < 0）。老年患者的疼痛比年轻患者更严重（4.15±2.89 vs 3.65±2.41,P < 0.001），老年患者的疼痛管理不足（75.47% vs 89.87%）。接受靶向或免疫辅助治疗（优势比[or]， 3.206； 95%可信区间[CI]， 1.538-6.684）和身体状况不佳（优势比[or]， 5.053; 95% CI, 2.023-12.622）成为疼痛管理不当的重要危险因素。结论：对于年龄≥60岁的患者，疼痛管理具有挑战性。因此，需要有针对性的干预措施来提高护理质量。
Pain and Its Treatment Among Outpatients with Malignant Tumors in China.
Background: Pain is common among patients with malignant tumors. It significantly impacts quality of life, yet over 80% of advanced cancer patients lack adequate pain management. Despite improvements in China's pain management program, challenges remain, especially for older adults and outpatient care.
Methods: We evaluated pain intensity management adequacy using a 0-10 numerical rating scale (NRS), and Pain Management Index (PMI) at an outpatient oncology clinic. Differences and changes in pain levels were statistically analyzed using t-test, rank-sum, and chi-square tests. Factors associated with inadequate pain management were identified using multivariate logistic regression.
Results: Among 589 participants, 45.41% scored moderate to severe pain ≥ 4, and 81.32% experienced inadequate pain management (PMI < 0). Pain was more severe among older, than younger patients (4.15 ± 2.89 vs 3.65 ± 2.41, P < 0.001) and pain management was inadequate in older compared with younger patients (75.47% vs 89.87%). Undergoing targeted or immune adjuvant therapy (odds ratio [OR], 3.206; 95% confidence interval [CI], 1.538-6.684) and poor physical status (OR, 5.053; 95% CI, 2.023-12.622) emerged as significant risk factors for inadequate pain management.
Conclusion: Pain management is challenging for patients aged ≥60 years. Therefore, tailored interventions are needed to enhance care quality.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
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