CANCER PAIN RELIEF SKILLS FOR MINORITY OUTPATIENTS

大多数门诊转移性癌症患者都有疼痛。 三分之一的人疼痛严重，这限制了他们的能力 功能。来自服务不足人群的癌症门诊患者在 疼痛管理不善的风险特别高；这些患者有三个 按照世界卫生组织的标准，最有可能开出的时间 止痛药太弱，无法控制他们的疼痛。我们的数据显示，超过60% 非裔美国人和超过80%的西班牙裔癌症门诊患者- 相关疼痛得到的止痛药处方不足。和以前一样 非少数族裔患者，这些患者往往夸大了担忧 限制他们报告疼痛和使用镇痛剂。他们还面临着 疼痛管理的额外障碍是接触有限的 提供者，难以支付药物费用，以及更好的医疗保健 对上瘾的专业关注。在我们的研究中，超过两倍于 来自这些群体的许多患者报告说，他们需要更多的疼痛 并需要更多有关疼痛管理的信息 少数族裔患者。对这些患者进行有关疼痛及其管理的教育 用他们需要的技能来培训他们获得疼痛缓解应该 改善他们的疼痛控制，提高他们的功能能力。 该项目将评估少数群体较低社会经济癌症的需求 门诊患者获取管理疼痛所需的信息和技能，开发 多媒体教育和培训材料，在语言和 在文化上适合西班牙裔和非裔美国人。至 完成这些任务我们已经(A)形成了一个由三个城市公众组成的网络 治疗这些病人的医院门诊部；及(B)建立 一个由多学科调查人员和顾问组成的团队 满足项目目标所需的专业知识。我们将评估 本培训方案的有效性在随机、对照中进行 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以及与疾病相关的疼痛。如果这个 方案是有效的，它可以很容易地被其他护理中心引入 这些病人在那里接受治疗。

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.