Heart Failure: The Hidden Problem of Pain
Heart Failure: The Hidden Problem of Pain
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DOI：
10.1016/j.jpainsymman.2009.04.022
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发表时间：
2009-11-01
影响因子：
4.7
通讯作者：
Lorenz, Karl A.
中科院分区：
文献类型：
--
作者：
Goebel, Joy R.;Doering, Lynn V.;Lorenz, Karl A.
尽管呼吸困难和疲劳是心力衰竭（HF）的标志性症状，但疼痛负担可能未得到充分认识。本研究评估了心力衰竭患者的疼痛情况并确定了相关影响因素。作为一项多中心研究的一部分，96名患有心力衰竭的退伍军人（96%为男性，年龄67±11岁）完成了症状、疼痛（简明疼痛量表[BPI]）、功能状态（功能疾病指数）和心理状态（患者健康问卷 - 2和广泛性焦虑障碍 - 2）的评估。来自BPI干扰项以及生活质量 - 临终项的单个项目评估了社会和精神健康状况。人口统计学和临床变量通过病历查阅获得。相关分析和线性回归模型评估了与疼痛相关的生理、情感、社会和精神因素。53名（55.2%）心力衰竭患者报告有疼痛，其中大多数（36名[37.5%]）将其疼痛评定为中度至重度（疼痛评分≥4/10）。疼痛的出现比呼吸困难更为频繁（67名[71.3%]对58名[61.7%]）。年龄（P = 0.02）、心理（抑郁：P = 0.002；焦虑：P = 0.001）、社会（P < 0.001）、精神（P = 0.010）和生理（健康状况：P = 0.001；症状频率：P = 0.000；功能状态：P = 0.002）健康状况与疼痛严重程度相关。在所得模型中，疼痛严重程度38%的变异得到了解释（P < 0.001）；人际关系干扰（P < 0.001）和症状数量（P = 0.007）对疼痛严重程度有影响。生理、心理、社会和精神领域与疼痛的关联表明，需要多学科干预来解决心力衰竭患者疼痛的复杂性质。《疼痛症状管理杂志》2009年；38卷：698 - 707页。（C）2009美国癌症疼痛缓解委员会。爱思唯尔公司出版。保留所有权利。
Although dyspnea and fatigue are hallmark symptoms of heart failure (HF), the burden of pain may be underrecognized. This study assessed pain in HF and identified contributing factors. As part of a multicenter study, 96 veterans with HF (96% male, 67 +/- 11 years) completed measures of symptoms, pain (Brief Pain Inventory [BPI]), functional status (Functional Morbidity Index), and psychological state (Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2).,Single items from the BPI interference and the quality of life-end of life measured social and spiritual Well-being. Demographic and clinical variables were obtained by chart audit. Correlation and linear regression models evaluated physical, emotional, social, and spiritual factors associated with, pain. Fifty-three (55.2%) HF patients reported pain, with a majority (36 [37.5%]) rating their pain as moderate to severe (pair >= 4/10). The Presence of pair, was reported more frequently than dyspnea (67 [71.3%] vs. 58 [61.7%]). Age (P = 0.02), psychological (depression: P = 0.002; anxiety: P= 0.001), social, (P < 0.001), spiritual (P= 0.010), and physical (health. status: P = 0.001; symptom frequency: P = 0.000; functional status: P = 0.002) well-being were correlated with pain severity. In the resulting model, 38% of the. variance in pair, severity was explained, (P < 0.001); interference with relations (P < 0.001) and symptom number (P = 0.007) contributed, to pain severity. The association of physical, psychological, social, and spiritual domains With pain suggests that multidisciplinary interventions are needed to address the complex nature of pain in HE J Pain Symptom Manage 2009;38:698-707. (C) 2009 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.