1 Nursing Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
2 Jixiang Otorhinolaryngology and Neurology Clinic, Tao-Yuan, Taiwan, R.O.C.
Clinical practice data about good pain management (GPM) implementation is still lacking in Taiwan. The purpose of this study is to investigate the effectiveness and feasibility of GPM.
From June 1, 2018 to December 31, 2018, a total of 48 patients with moderate to severe pain were included in the analyses prospectively. Pain intensity was evaluated by using the numerical rating scale (NRS). Presence of neuropathic
pain was evaluated by using the Douleur Neuropathique 4 questionnaire. The Revised American Pain Society Patient Outcome Questionnaire, including six core quality indicators, was filled out during initial admission, 24±4 hours, 48±4 hours, and 72±4 hours after admission.
There were 26 males and 22 females. The types of cancer were mainly pancreatic cancer (37.5%), head and neck cancer (16.6%) and gastric cancer (16.6%). Our patients experienced a significant pain improvement after regular assessments and pain medication adjustment (p< 0.05; Table 3, Figure 1). Six patients failed to reach the 333 index of cancer pain control . After completion of the study, our patients were divided into two groups: well-controlled group (NRS<4,
n=42) and poorly-controlled group (NRS≥4, n=6). The average age was 55.0 in well-controlled group and 53.5 in poorly-controlled group. Only one patient was eligible for neuropathic pain. In the poorly-controlled group, the emotional impact
severity scores were slightly higher than those of the well-controlled group at the four survey time points (Figure 4). The impacts of disease severity and drug side effects on pain were unremarkable (Figure 3, Figure 5).
Our study suggest GPM implementation is effective and feasible for moderate to severe cancer pain. If the patient's pain is not well controlled, psychological counseling and necessary interventions might be considered.
Hsiu-Yun Huang, Pei-Chao Lin, Pi-Ling Chou, Yueh-Mei Tseng, Li-Chuan Wu
The Experiences and Outcomes of Promoting Cancer Painless College at a Medical Center
The Journal of Oncology Nursing. 2019; 19, 183-193.
Shiao-Pei Hong, Hui-Mei Huang, Li-Hua Tseng, Jin-Lain Ming
The Role of Nurse to Promote the Pain-free Hospital
HOSPITAL. 2015; 48(3), 48-57.
Yi-Ping Hung, Yi Zhao, Chung-Pin Li
The latest progress of immunotherapy for gastrointestinal cancers
Clinical Medicine. 2019; 83(4), 246-249.
Yang YP, Ma YX, Huang Y, et al
The good pain management (GPM) ward program in China and its impact on Chinese cancer patients the SYSUCC experience.
Chinese journal of cancer. 2014; 33, 323-329.
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.
European journal of pain. 2005; 9(5), 485-495.
Wang K, Chen Z, Meng Z, et al
Analgesic effect of high intensity focused ultrasound therapy for unresectable pancreatic cancer.
International journal of hyperthermia. 2011; 27(2), 101-107.
臺北榮民總醫院護理部品質管理委員會 (2019， 10 月修訂 )
疼痛評估護理 . 台北：臺北榮民總醫院 .
Syrjala KL, Jensen MP, Mendoza ME, et al
Psychological and behavioral approaches to cancer pain management.
Journal of clinical oncology. 2014; 32(16), 1703–1711.
Neuroimaging mechanisms in pain: from discovery to translation.
Pain. 2017; 158(Suppl 1), S115–S122.