Minority cancer patients and their providers - Pain management attitudes and practice
Minority cancer patients and their providers - Pain management attitudes and practice
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少数族裔癌症患者及其医疗服务提供者--疼痛管理态度与实践
DOI：
10.1002/(sici)1097-0142(20000415)88:8
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发表时间：
2000-04-15
期刊：
影响因子：
6.2
通讯作者：
Cleeland, CS
中科院分区：
文献类型：
--
作者：
Anderson, KC;Mendoza, TR;Cleeland, CS
背景目前研究的目标是：1）确定社会经济上处于不利地位的非洲裔美国人和西班牙裔复发性或转移性癌症患者的疼痛治疗需求，2）评估治疗他们的医疗保健专业人员的高度。在第一项研究中，108名患有转移性或复发性癌症和疼痛的非洲裔美国人和西班牙裔患者完成了一项关于他们疼痛强度，疼痛干扰和对镇痛药物态度的调查。医生还评估了患者的疼痛程度，并评估了患者目前止痛处方的充分性。在第二项研究中，55名医生和护士治疗这些患者完成了一份问卷调查，关于癌症疼痛及其管理在他们的实践settings.RESULTS，大约28%的西班牙裔和31%的非洲裔美国患者接受止痛药的强度不足，以管理他们的疼痛。尽管大多数患者接受了适当的镇痛药，但65%的患者报告了重度疼痛。医生低估了64%的西班牙裔和74%的非洲裔美国患者的疼痛严重程度。医生比男性患者更容易低估女性患者的疼痛严重程度。不充分的疼痛评估，病人不愿意报告疼痛，以及缺乏工作人员的时间被认为是疼痛管理的障碍。尽管数据表明最近非洲裔美国人和西班牙裔癌症患者的止痛药处方实践有所改善，但大多数患者报告疼痛程度高，止痛药的疼痛缓解有限。疼痛评估不足仍然是最佳癌症疼痛治疗的主要障碍。癌症2000;88：1929-38. (C)2000美国癌症协会
BACKGROUND. The goals of the current studies were: 1) to determine the pain treatment needs of socioeconomically disadvantaged African-American and Hispanic patients with recurrent or metastatic cancer and 2) to assess the altitudes of health care professionals who treat them.METHODS. In the first study 108 African-American and Hispanic patients with metastatic or recurrent cancer and pain completed a survey about their pain intensity, pain interference, and attitudes toward analgesic medications. Physicians also rated their patients' pain and the adequacy of the patients' current analgesic prescriptions was assessed. In the second study 55 physicians and nurses who treat these patients completed a questionnaire regarding cancer pain and its management in their practice settings.RESULTS, Approximately 28% of the Hispanic and 31% of the African-American patients received analgesics of insufficient strength to manage their pain. Although the majority of patients received appropriate analgesics, 65% reported severe pain. Physicians underestimated pain severity for 64% of the Hispanic and 74% of the African-American patients. Physicians were more likely to underestimate the pain severity of female patients than male patients. Inadequate pain assessment, patient reluctance to report pain, and lack of staff time were perceived as barriers to pain management.CONCLUSIONS. Although the data suggest recent improvements in analgesic prescribing practices for African-American and Hispanic cancer patients, the majority of patients reported high levels of pain and limited pain relief from analgesic medications. Inadequate pain assessment remains a major barrier to optimal cancer pain treatment. Cancer 2000;88:1929-38. (C) 2000 American Cancer Society.