以疼痛緩解指數檢視癌症病人住院天數與疼痛緩解之相關性

Association between the Pain Relief Index and Hospital Stay among Cancer Inpatients

王蔚芸(Wei-Yun Wang) ； 朱基銘(Chi-Ming Chu) ； 宋俊松(Chun-Sung Sung) ； 王桂芸(Kwua-Yun Wang)

《台灣醫學》 22卷5期 (2018/09) Pp. 465-473

https://doi.org/10.6320/FJM.201809_22(5).0001

摘要

癌症病人住院天數愈長，疼痛愈嚴重，是否代表疼痛緩解愈差，仍待研究證實，故本研究目的為藉由巨量疼痛資料檢視癌症病人之住院天數與疼痛緩解之相關性，而疼痛緩解則以疼痛緩解指數（pain relief index，PRI）來檢視某醫學中心2011年至2013年住院癌症病人的疼痛治療成效。護理師使用數字類比量表、臉譜量表或臉、腿、活動、哭泣、安撫行為工具評值疼痛，並利用護理資訊系統進行疼痛分數之紀錄、萃取及分析，結果發現中、重度疼痛之癌症住院病人疼痛緩解約62-73％，以老年族群疼痛緩解較佳，重度疼痛且住院天數超過30天之癌症病人，疼痛緩解較不足。未來應可更進一步檢視不同族群病人之疾病屬性，疾病嚴重度等因素與疼痛管理之成效，並由不同面向定義PRI其百分比改變之意義。

關鍵字

疼痛 ； 測量 ； 癌症 ； 護理資訊學 ； 醫院

並列摘要

Cancer patients with longer hospitalization period have more severe pain. The aim of this study was to examine the association between hospital stay and pain relief using a new indicator- pain relief index (PRI) in a database of cancer inpatients from 2011 through 2013. Pain intensity was assessed by a numerical rating scale, a faces pain scale or the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Tool. Using a nursing information system (NIS), a pain score was retrieved and analyzed. The results demonstrated that the cancer patients for whom the worst pain intensity (WPI) ≥ 4 points had PRI values around 62% to 73%. The elder patients had better pain relief, but severe cancer pain patients with hospital stay more than 30 days had less pain relief. In the future, we can examine related factors such as disease characteristics, severity and the outcome of pain management in different populations. We will also define the meaning of PRI percentage variation in different aspects.

並列關鍵字

pain ； measurement ； cancer ； nursing informatics ； hospital

參考文獻

Luckett T, Davidson PM, Green A, et al: Assessment and management of adult cancer pain: A systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. J Pain Symptom Manage 2013;46:229-53.

Melotti RM, Samolsky-Dekel BG, Ricchi E, et al: Pain prevalence and predictors among inpatients in a major Italian teaching hospital. A baseline survey towards a pain free hospital. Eur J Pain 2005;9:485-95.

Foley KM: How well is cancer pain treated? Palliat Med 2011;5: 398-401."

Mearis M, Shega JW, Knoebel RW: Does adherence to National Comprehensive Cancer Network guidelines improve pain-related outcomes? An evaluation of inpatient cancer pain management at an academic medical center. J Pain Symptom Manage 2014;48:451-8.

Lucenteforte E, Collini F, Simonetti M, et al: Assessing pain in hospital in-patients: A cross- sectional study in Tuscany, Italy. Intern Emerg Med 2012;7:477-82.