Acute oral pain and mucositis in bone marrow transplant and leukemia patients: data from a pilot study.
Acute oral pain and mucositis in bone marrow transplant and leukemia patients: data from a pilot study.
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骨髓移植和白血病患者的急性口腔疼痛和粘膜炎：来自一项试点研究的数据。
DOI：
10.1097/00002820-199812000-00002
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Wingard,JR
中科院分区：
文献类型：
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作者：
McGuire,DB;Yeager,KA;Dudley,WN;Peterson,DE;Owen,DC;Lin,LS;Wingard,JR
这项前瞻性、重复测量的描述性试点研究的目的是描述接受骨髓移植或高剂量白血病化疗的患者的急性口腔疼痛和粘膜炎模式，并在开始更大规模的干预研究之前测试程序和仪器。采用非概率、有目的的选择过程，招募了 18 名患者，这些患者入住美国东南部一所大学健康科学中心的两个急症护理住院病房，进行骨髓移植或白血病治疗。在基线时收集数据，然后每天通过患者访谈、口腔检查和图表审查收集数据，持续至少三周或直至出院。研究变量包括疼痛强度、难以忍受的疼痛、疼痛的言语描述、疼痛缓解和疼痛缓解策略的使用（疼痛评估表）、口腔八个解剖位置的粘膜炎（红斑和溃疡）（口腔粘膜炎指数）、声音/说话（口腔评估指南）和情绪状态（情绪状态的 11 项简要概况）。近 70% 的患者出现轻度至中度疼痛，并被描述为“压痛”、“刺激性”和“疼痛”。患者使用止痛药、口腔护理以及精神和身体活动来缓解疼痛，并报告疼痛得到部分总体缓解。粘膜炎较轻，最常见的是舌头、颊粘膜和唇粘膜出现红斑，颊粘膜出现溃疡。声音/说话仅轻度受损，情绪障碍也很轻微。疼痛、粘膜炎和情绪障碍的模式彼此一致，并且遵循先前研究中描述的轨迹。结果表明，护士应继续积极评估这些症状，并协助患者选择多种治疗策略。在这种重症住院患者群体中使用重复测量设计的研究具有挑战性，需要研究人员的认真关注。结果已用于改进正在进行的更大规模的干预研究。
The purposes of this prospective, repeated-measures descriptive pilot study were to describe patterns of acute oral pain and mucositis in patients receiving a bone marrow transplant or high-dose chemotherapy for leukemia, and to test procedures and instruments before initiating a larger intervention study. A nonprobability, purposive selection process was used to enroll 18 patients admitted to two acute care inpatient hospital units for bone marrow transplantation or leukemia therapy at a university health sciences center in the southeastern United States. Data were collected at baseline, then daily through patient interviews, oral examination, and chart review for at least 3 weeks or until discharge. Research variables were pain intensity, intolerable pain, verbal descriptors of pain, pain relief, and use of pain relief strategies (Pain Assessment Form), mucositis (erythema and ulceration) in eight anatomic locations of the oral cavity (Oral Mucositis Index), voice/talking (Oral Assessment Guide), and mood states (11-item Brief Profile of Mood States). Mild to moderate pain occurred in nearly 70% of patients and was described as" tender,"" irritating," and" sore." Patients used pain medicines, mouth care, and mental and physical activities to relieve pain, and reported partial overall relief of pain. Mucositis was mild, with the tongue and buccal and labial mucosa most commonly affected with erythema and the buccal mucosa with ulceration. Voice/talking were only mildly impaired, and mood disturbance was mild. Patterns of pain, mucositis, and mood disturbance were consistent with each other and followed the trajectory described in previous research. Results suggest that nurses should continue to assess these symptoms vigorously and assist patients in selecting multiple management strategies. Research using repeated-measures designs in this acutely ill inpatient population is challenging and needs careful attention by researchers. The results have been used to improve the ongoing larger intervention study.