How does pain experience relate to the need for pain relief? A secondary exploratory analysis in a large sample of cancer patients
How does pain experience relate to the need for pain relief? A secondary exploratory analysis in a large sample of cancer patients
复制标题
疼痛体验与缓解疼痛的需要有何关系？
DOI：
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发表时间：
2016
影响因子：
3.1
通讯作者：
M. Groenvold
中科院分区：
文献类型：
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作者：
A. T. Johnsen;M. Petersen;C. Snyder;L. Pedersen;M. Groenvold
目的探讨(1)从相关但概念不同的疼痛评估方法中获得的信息；(2)欧洲癌症研究与治疗组织生活质量问卷-核心30 （EORTC QLQ-C30）作为预测患者报告的疼痛缓解需求的筛选工具的程度。方法从56个医院科室随机抽取肿瘤患者。问卷项目分别使用EORTC QLQ-C30疼痛量表及其两个疼痛项目（疼痛强度和疼痛干扰）评估患者(a)疼痛体验，(b)疼痛负担和(c)疼痛缓解需求使用三级需求问卷（3LNQ）。结果通过邮件联系的2364例患者中，有1447例（61%）完成了问卷调查。在这些人中，51%的人在疼痛强度项目上至少有“一点”疼痛。报告疼痛为负担的患者数量相似，疼痛经历与疼痛负担高度相关（相关系数为0.85 ~ 0.91）。疼痛经历和疼痛负担与缓解疼痛的需要有中度相关。受试者工作特征（ROC）曲线分析显示，EORTC QLQ-C30在可接受程度（曲线下面积（AUC） 0.73-0.77）上区分了是否需要缓解疼痛的患者。“你有过疼痛吗？”这一问题的敏感度和特异性分别为84%和59%，而疼痛量表的敏感度和特异性分别为72%和72%。结论：大多数经历过疼痛的患者认为这是一个问题。疼痛体验和疼痛负担与疼痛缓解需求显著相关，后者可以通过EORTC QLQ-C30预测。
PurposeTo explore (1) the information obtained from related but conceptually different approaches to pain assessment and (2) the extent to which the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) can be used as a screening tool to predict patient-reported need for pain relief.MethodsCancer patients randomly sampled from 56 hospital departments were included. Questionnaire items assessed patients’ (a) pain experience using the EORTC QLQ-C30 pain scale and its two pain items separately (pain intensity and pain interference) and (b) pain burden and (c) need for pain relief using the Three-Levels-of-Needs Questionnaire (3LNQ).ResultsOf the 2364 patients contacted by mail, 1447 (61 %) completed the questionnaires. Among these, 51 % reported at least “a little” pain on the pain intensity item. The number of patients reporting pain to be a burden was similar, and pain experience and pain burden were highly correlated (correlation coefficients ranged from 0.85 to 0.91). Pain experience and pain burden were moderately correlated with the need for pain relief. A receiver-operating characteristic (ROC) curve analysis showed that the EORTC QLQ-C30 discriminated between patients with and without a need for pain relief to an acceptable degree (area under the curve (AUC) 0.73–0.77). The cut-point a little gave a sensitivity of 84 % and specificity of 59 % for the item “Have you had pain?” and a sensitivity of 72 % and a specificity of 72 % for the pain scale.ConclusionsThe majority of patients who experienced pain felt it to be a problem. Pain experience and pain burden were substantially related to need for pain relief, and the latter could be predicted from the EORTC QLQ-C30.