Chronic pain severity, impact, and opioid use among patients with cancer: An analysis of biopsychosocial factors using the CHOIR learning health care system.
Chronic pain severity, impact, and opioid use among patients with cancer: An analysis of biopsychosocial factors using the CHOIR learning health care system.
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癌症患者的慢性疼痛严重程度、影响和阿片类药物的使用：使用唱诗班学习卫生保健系统对生物、心理和社会因素的分析。
DOI：
10.1002/cncr.33645
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发表时间：
2021-09-01
期刊：
影响因子：
6.2
通讯作者：
Mackey, Sean
中科院分区：
文献类型：
--
作者：
Azizoddin, Desiree R.;Schreiber, Kristin;Beck, Meghan R.;Enzinger, Andrea C.;Hruschak, Valerie;Darnall, Beth D.;Edwards, Robert R.;Allsop, Matthew J.;Tulsky, James A.;Boyer, Edward;Mackey, Sean
关键词：
尽管慢性非癌症疼痛的生物心理社会基础，相对较少的是知道的心理社会因素的贡献，慢性癌症疼痛。作者旨在描述慢性疼痛和癌症患者中生物心理社会因素与疼痛和阿片类药物使用之间的关联。作者对700名在学术三级疼痛诊所寻求治疗的慢性疼痛和癌症患者进行了回顾性横断面研究。患者完成了人口统计学问卷调查，并验证了社会心理和疼痛措施。多变量、分层线性和逻辑回归评估了生物心理社会因素对疼痛严重程度、疼痛干扰和阿片类药物使用的主要因变量的相对贡献。参与者中62%为女性，66%为白色，平均年龄为59 ± 15岁，55%拥有大学或更高学历。年龄较大、非裔美国人或"其他"种族、睡眠障碍和疼痛灾难化与较高的疼痛严重程度显著相关（F（5，657）= 22.45; P ≤ 0.001; R2 = 0.22）。抑郁、睡眠障碍、疼痛灾难化、较低的情感支持和较高的疼痛严重程度与疼痛干扰显著相关（F（5，653）= 9.47; P ≤ 0.001; R2 = 0.44）。最后，癌症预后不良（Exp（B）= 1.62）和睡眠障碍（Exp（B）= 1.02）与服用阿片类药物相关，而亚洲人（Exp（B）= 0.48）或西班牙人（Exp（B）= 0.47）与使用阿片类药物的几率较低相关。可改变的心理因素，特别是睡眠障碍，抑郁症和疼痛灾难，与慢性疼痛和各种癌症诊断患者的疼痛和阿片类药物使用独特相关。未来同时针对睡眠的行为疼痛干预可能会改善癌症患者的疼痛。·感到沮丧，担心疼痛和睡眠不好与慢性疼痛和癌症患者的疼痛症状有关。·具体来说，那些难以入睡的人疼痛更严重，使用更多的阿片类药物。此外，癌症预后不良的人更有可能使用阿片类止痛药。虽然种族和癌症与患者的慢性疼痛有关，但心理健康也与这种疼痛密切相关。
Despite the biopsychosocial underpinnings of chronic noncancer pain, relatively little is known about the contribution of psychosocial factors to chronic cancer pain. The authors aimed to characterize associations between biopsychosocial factors and pain and opioid use among individuals with chronic pain and cancer. The authors conducted a retrospective, cross-sectional study of 700 patients with chronic pain and cancer seeking treatment at an academic tertiary pain clinic. Patients completed demographic questionnaires and validated psychosocial and pain measures. Multivariable, hierarchical linear and logistic regressions assessed the relative contributions of biopsychosocial factors to the primary dependent variables of pain severity, pain interference, and opioid use. Participants were 62% female and 66% White with a mean age of 59 ± 15 years, and 55% held a college degree or higher. Older age, African American or “other” race, sleep disturbance, and pain catastrophizing were significantly associated with higher pain severity (F(5,657) = 22.45; P ≤ .001; R2 = 0.22). Depression, sleep disturbance, pain catastrophizing, lower emotional support, and higher pain severity were significantly associated with pain interference (F(5,653) = 9.47; P ≤ .001; R2 = 0.44). Lastly, a poor cancer prognosis (Exp(B) = 1.62) and sleep disturbance (Exp(B) = 1.02) were associated with taking opioids, whereas identifying as Asian (Exp(B) = 0.48) or Hispanic (Exp(B) = 0.47) was associated with lower odds of using opioids. Modifiable psychological factors—specifically sleep disturbance, depression, and pain catastrophizing—were uniquely associated with pain and opioid use in patients with chronic pain and diverse cancer diagnoses. Future behavioral pain interventions that concurrently target sleep may improve pain among patients with cancer. • Feeling depressed, worrying about pain, and bad sleep are related to higher pain symptoms in individuals with chronic pain and cancer. • Specifically, those who struggle to sleep have worse pain and use more opioids. • Also, individuals who have a bad prognosis for their cancer are more likely to be using opioid pain medications. • Although race and cancer are related to chronic pain in patients, psychological well-being is also strongly related to this same pain.
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影响因子：
3.1
作者：
Lai, YH;Guo, SL;Chen, ML
通讯作者：
Chen, ML
影响因子：
2.9
作者：
Edmond, Sara N.;Shelby, Rebecca A.;Bovbjerg, Dana H.
通讯作者：
Bovbjerg, Dana H.
DOI：
10.14694/edbk_180469
发表时间：
2017-01-01
期刊：
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
影响因子：
--
作者：
Bennett, Mike;Paice, Judith A;Wallace, Mark
通讯作者：
Wallace, Mark
影响因子：
28.4
作者：
Agarwal, Ankit;Roberts, Andrew;Royce, Trevor J.
通讯作者：
Royce, Trevor J.
DOI：
10.1016/j.jpain.2015.05.009
发表时间：
2015-09
期刊：
The journal of pain
影响因子：
--
作者：
Meghani SH;Thompson AM;Chittams J;Bruner DW;Riegel B
通讯作者：
Riegel B