Pain in Underserved Community-Dwelling Chinese American Cancer Patients: Demographic and Medical Correlates
Pain in Underserved Community-Dwelling Chinese American Cancer Patients: Demographic and Medical Correlates
复制标题
DOI：
10.1634/theoncologist.2010-0330
复制
发表时间：
2011-01-01
期刊：
影响因子：
5.8
通讯作者：
Portenoy, Russell
中科院分区：
文献类型：
--
作者：
Dhingra, Lara;Lam, Kin;Portenoy, Russell
背景关于华裔美国人的癌症疼痛知之甚少。本研究的目的是描述这一人群中疼痛的流行病学。需要这些信息来识别和解决未满足的临床需求，以针对疼痛及其后果的文化相关干预措施。在一个大型的社区肿瘤学实践中，对服务不足的华裔患者的连续样本进行持续性或频繁性疼痛筛查。这些疼痛患者完成翻译的工具，评估人口统计学，语言文化适应，疾病相关的特点，和疼痛相关的特点。在筛选的312例患者中，178例（57.1%）报告了频繁或持续性疼痛，175例合格，170例参与。大多数参与者（85.9%）出生在中国，84.7%的人只说广东话。最常见的癌症是胃肠道（28.2%）、肺（21.8%）、乳腺（20.6%）、头颈部（12.9%）和泌尿生殖系统（4.7%）; 43.5%有转移性疾病。在0-10数字量表上，平均最严重疼痛严重程度为4.7（标准差为2.4），28.2%的患者将其最严重疼痛评分为≥ 7/10。虽然37.6%的人使用阿片类药物，47.1%的人使用非阿片类药物，但45.8%的人报告药物“很少”或“没有”疼痛缓解。35.8%的患者使用补充或替代药物治疗癌痛。在多元回归分析中，最严重的疼痛与英语文化适应和阿片类药物治疗呈正相关，疼痛相关的痛苦与阿片类药物治疗呈正相关。疼痛在社区居住的华裔美国癌症患者中普遍存在。需要更多的研究来证实这些结果，并调查发现，更高的语言文化适应与更强烈的疼痛报告。肿瘤学家2011;16：523-533
Background. Little is known about cancer pain in Chinese Americans. The objective of this study was to describe the epidemiology of pain in this population. This information is needed to identify and address unmet clinical needs for culturally relevant interventions targeting pain and its consequences.Methods. A consecutive sample of underserved ethnic Chinese patients in a large community-based oncology practice was screened for persistent or frequent pain. Those patients with pain completed translated instruments assessing demographics, linguistic acculturation, disease-related characteristics, and pain-related characteristics.Results. Of 312 patients screened, 178 (57.1%) reported frequent or persistent pain, 175 were eligible, and 170 participated. Most participants (85.9%) were born in China and 84.7% overall spoke Cantonese only. The most common cancers were gastrointestinal (28.2%), lung (21.8%), breast (20.6%), head and neck (12.9%), and genitourinary (4.7%); 43.5% had metastatic disease. The mean worst pain severity on a 0-10 numeric scale was 4.7 (standard deviation, 2.4), with 28.2% of patients rating their worst pain at >= 7 of 10. Although 37.6% used opioids and 47.1% used nonopioids, 45.8% reported "little" or "no" pain relief from medications. Complementary or alternative medicine therapies for cancer pain were used by 35.8%. In multiple regression analyses, worst pain was positively associated with acculturation to the English language and opioid therapy, and pain-related distress was positively associated with opioid therapy.Conclusion. Pain is prevalent among community-dwelling, ethnic Chinese American cancer patients. Additional studies are needed to confirm these results and investigate the finding that higher linguistic acculturation is associated with reports of more intense pain. The Oncologist 2011;16:523-533