CANCER PAIN RELIEF SKILLS FOR MINORITY OUTPATIENTS

大多数门诊转移性癌症患者有疼痛 三分之一的人有严重的疼痛， 功能来自服务不足人群的癌症门诊患者在 尤其是疼痛管理不良的风险高;这些患者是三个 按照世界卫生组织的标准， 止痛剂太弱，无法控制疼痛。我们的数据显示， 非洲裔美国人和超过80%的西班牙裔癌症门诊患者中， 相关疼痛的患者接受的止痛药处方不足。如同 非少数民族患者，这些患者往往有夸大的担忧， 限制他们报告疼痛和使用止痛药。他们也面临 疼痛管理的其他障碍， 供应商，支付药物的困难，以及更大的医疗保健 对成瘾的专业关注。在我们的研究中， 这些群体中的许多患者报告说，他们需要更多的疼痛 药物治疗和需要更多的信息，疼痛管理比不 少数民族患者教育这些患者有关疼痛及其管理 并训练他们获得止痛所需的技能， 改善他们的疼痛控制并提高他们的功能。 该项目将评估少数族裔社会经济地位较低的癌症患者的需求， 门诊病人的信息和技能需要管理疼痛，发展 多媒体教育和培训材料， 文化上适合西班牙裔和非洲裔美国人。到 为完成这些任务，我们（一）形成了三个城市公共网络 治疗这些患者的医院门诊诊所，以及（B）建立 一个由调查员和顾问组成的多学科小组， 满足项目目标所需的专业知识。我们将评估 在一个随机、对照的 非裔美国人和西班牙裔门诊患者的临床试验， 转移性乳腺癌或前列腺癌和疾病相关的疼痛。如果这 该计划是有效的，它可以很容易地被其他护理中心引入 这些病人接受治疗的地方。

The majority of ambulatory outpatients with metastatic cancer have pain and one-third have pain so severe that it restricts their ability to function. Outpatients with cancer from underserved populations are at especially high risk for poor pain management; these patient are three times as likely, by World Health Organization standards, to be prescribed analgesics too weak to control their pain. Our data indicate that over 60% of African-American and over 80% of Hispanic outpatients with cancer- related pain receive less than adequate analgesic prescriptions. As with non-minority patients, these patients often have exaggerated concerns that limit their reporting of pain and their use of analgesics. They also face additional barriers to pain management in terms of limited contact with providers, difficulty paying for medications, and greater health care professional concern about addiction. In our studies, more than twice the number of patients from these groups report that they need more pain medication and need more information about pain management than do non- minority patients. Educating these patients about pain and its management and training them with the skills they need to obtain pain relief should improve their pain control and increase their ability to function. This project will assess the needs of minority lower socio-economic cancer outpatients for information and skills needed to manage pain, develop multi-media education and training materials that are linguistically and culturally appropriate for Hispanic and African American populations. To accomplish these tasks we have (a) formed a network of three urban public hospital outpatient clinics that treat these patients and (b) established a multi-disciplinary team of investigators and consultants with the expertise necessary to meet project goals. We will evaluate the effectiveness of this training program in a randomized, controlled clinical trial for African American and Hispanic outpatients with metastatic breast or prostate cancer and disease-related pain. If this program is effective, it can be easily be introduced by other care centers where these patients are treated.