医护人员及肿瘤患者对癌痛认知的调查分析  

Investigation on the cognition of cancer pain in medical staff and cancer patients

作　　者：杨璞[1] 朱建华[1] 肖文华[1] 刘家宏[1] 周旋[1] 李秋文[1] 

机构地区：[1]解放军总医院第一附属医院肿瘤一科,北京100048

出　　处：《实用疼痛学杂志》2015年第5期350-355,共6页Pain Clinic Journal

摘　　要：目的 调查医护人员对癌痛的认知以及肿瘤患者疼痛控制状况,观察目前癌痛控制中存在的问题,为完善癌痛管理提供依据.方法 采用自行设计的癌痛相关认知调查表调查我院肿瘤科及相关科室医护人员48名,及自行设计的肿瘤患者疼痛情况调查表调查就诊于我院肿瘤科的癌症患者321名.结果 81.3％ （39/48）的医护人员会在治疗前对疼痛患者进行全面评估;22.9％（11/48）认为初始出现疼痛时应首先转移患者注意力;81.3％（39/48）认为应通过患者主诉来评估癌痛患者的疼痛强度;仍有6.3％（3/48）医护人员不清楚WHO三阶梯止痛原则,10.4％（5/48）不清楚疼痛评分方法;27.1％（13/48）的医护人员选择哌替啶处理爆发痛;对于慢性癌痛的治疗45.8％ （22/48）认为应该按需给药;22.9％（11/48）的医护人员认为应当用阿片类药物出现副反应时再处理.调查的癌症患者中疼痛发生的比例为44.2％（142/321）.癌痛患者使用止痛药物的顾虑主要有：认为止痛药物会成瘾（38/124,30.6％）、认为止痛药物副作用太大,尽量不用（31/124,25.0％）、担心疼痛加重是病情进展的信号（19/124,15.3％）.结论 医护人员和患者对癌痛诊疗和药物使用方面普遍存在错误认知,我院癌痛规范化管理措施有待提高.Objective To investigate the cognition of pain in medical staff and pain control in cancer patients,find the problems in current cancer pain control and provide information for the improvement of pain management.Methods The pain related cognitive questionnaire survey was used to investigate 48 doctors and nurses in Department of Oncology of our hospital,and the cancer pain questionnaire survey was used to investigate 321 cancer patients in the same department.Results 81.3% （39/48） of the medical staff will conduct a comprehensive assessment before treating cancer pain patients,22.9% （1 1/48） thought when patients feel pain,the first thing to do was diverting his attention,81.3% （39/48） considered that it should be evaluated pain intensity by cancer patients＇ complaints,6.3% （3/48） of the medical staff didn＇t know the Guidelines of Pain Relief Ladder for Cancer Pains,10.4% （5/48） was not clear about pain score method.27.1% （13/48） of the medical staff chose pethidine to deal with outbreak pain,45.8% （22/48） of the medical staff thought on-demand delivery should be used in the treatment of chronic pain,22.9% （11/48） thought we should not handle the side effects of opioid until it appeared.The percentage of pain in cancer patients was 44.2% （142/321）.The main concerns of painful patients about using pain medications were drug addiction （38/124,30.6%） and the side effects（31/124,25.0%）,and considering pain as a sign of disease progression （19/124,15.3%）.Conclusion Misunderstanding on the usage and safety of analgesics and cancer pain management are common among medical staff and cancer pain patients.The cancer pain standardized management should be improved in our hospital.

关 键 词：医护人员 患者 肿瘤 疼痛 调查 

分 类 号：R971.1[医药卫生—药品]